Physician-Modified Versus Custom-Manufactured Fenestrated-Branched Endografts in the Treatment of Thoracoabdominal and Pararenal Aneurysms: A Vascular Quality Initiative–Medicare Analysis

Abstract

The use of fenestrated and branched endovascular aneurysm repair (F-BEVAR) has expanded the indications for endovascular repair to patients with thoracoabdominal aortic aneurysms (TAAAs) and pararenal aortic aneurysms (PRAs). Previous reports have indicated that F-BEVAR can be performed with high technical success and lower morbidity and mortality compared with open repair. Although custom-manufactured devices (CMDs) that have been tailored to the patient’s anatomy have been proved effective, their widespread use has been hampered by regulatory issues, the costs, and delays required for device manufacturing.