Expanding the applicability of the off-the-shelf multibranched thoracoabdominal aortic device beyond the anatomic boundaries

Abstract

Fenestrated, branched endovascular aortic aneurysm repair has been widely adopted by many centers as the treatment of choice for complex abdominal and thoracoabdominal aortic aneurysms. The concept of off-the-shelf devices with designs to accommodate most patient anatomic variations contrasts with custom devices that contain anatomically specific fenestrations or branches. Reported applicability of off-the-shelf devices has varied widely in the literature, from less than half to the vast majority approaching 90%, with analyses mostly based on the relative positions of the visceral renal arteries in patients with complex abdominal or thoracoabdominal aortic aneurysms.