When Aneurysms Need Waiting, and Not Worrying… Commentary on “Initial Results of Antegrade Laser Fenestrations Using Image Fusion Guidance and Company Manufactured Stent Grafts in Complex Aortic Aneurysm Repair”

Abstract

Sénémaud et al. report the largest experience of physician modified stent grafts using antegrade laser fenestrations and image fusion guidance (LEVAR) in aortic aneurysm repair.1 They evaluated short term outcomes of LEVAR for the treatment of complex abdominal aortic aneurysms, thoraco-abdominal aortic aneurysms, and type I endoleaks and reported satisfactory 12 month overall survival and target vessel patency rates.1 These results are of importance since custom device manufacture usually requires from six to 12 weeks, which precludes their use in emergency cases such as symptomatic or large aneurysms with impending rupture.