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Fenestrated endovascular aortic repair (FEVAR) stent grafting is a minimally invasive procedure and an alternative to open surgical repair for abdominal aortic aneurysm repair, particularly with unideal neck anatomy. Planning and implementing a custom FEVAR graft is complicated, requiring advanced training and years of practice. As such, a method for creating a patient-specific, to-scale, cost-effective, 3-dimensional abdominal aortic aneurysm model for use in preoperative planning is presented. The model can be used to help physicians create custom FEVAR grafts, thus eliminating the currently used difficult and technical method for creating custom grafts. It also can assist physicians in visualizing and practicing their surgical approach for a specific patient., (Copyright © 2018 Elsevier Inc. All rights reserved.)

Thoracoabdominal aortic aneurysm (TAAA) repair has a rich and storied tradition that began in Houston, Texas with great pioneer surgeons such as Drs Michael E. DeBakey, Denton A. Cooley, and E. Stanley Crawford. Their early attempts to repair TAAA were complicated by the persistent threats of renal and spinal cord ischemia and difficulty in reattaching the branching vessels of the thoracoabdominal aorta. Today, under the tutelage of Dr Joseph S. Coselli, the Texas Medical Center remains at the forefront of TAAA repair. In this place where great surgeons once walked the halls, their legacy continues., (Copyright © 2019 Elsevier Inc. All rights reserved.)

Thoracic endovascular aortic repair (TEVAR) is a rapidly growing and improving technique for the management of thoracic aortic aneurysms, dissections, and traumatic aortic injury. These disease processes were previously treated exclusively by surgery, but TEVAR has substantially improved patient outcomes including reduced mortality, reduced paraplegia rate, and shorter hospital and/or intensive care unit stay compared to open surgery. TEVAR was initially isolated to the descending thoracic aorta, but the advent of advanced techniques has extended the scope to well beyond the left subclavian artery and into Zone 0. Recent techniques include chimney grafts, periscope grafts, in situ fenestrations, and physician modified grafts. In addition, commercial branched aortic devices are currently on trial and will likely vastly extend the off-the-shelf capabilities of TEVAR for aortic arch disease. This paper reviews the data, concepts, and technical aspects of current advanced TEVAR techniques, as well as ongoing clinical trials for thoracic branched aortic devices., (Copyright © 2018. Published by Elsevier Inc.)

Parodi first introduced endovascular aneurysm repair (EVAR) in 1991 and since that time it has been shown to have a lower 30-day morbididty and mortality compared to open surgery. Anatomic constraints governed by the need for adequate access vessels, and sufficient proximal and distal landing zones, as well as the need for long-term surveillance, have been the main limitations of this technology. Anatomic factors were initially estimated to exclude 40% of patients with abdominal aortic aneurysm (AAA). The rapid extension of EVAR technology has been complimented by improved access to both high-quality imaging modalities and a variety of endografts. These developments have led EVAR to become a more practical alternative for patients with ruptured AAA. Early data in this setting is encouraging with even more profound reductions in morbidity and mortality than seen in the elective repair., (Copyright © 2012 Elsevier Inc. All rights reserved.)

Since the original descriptions of endovascular grafts for treatment of aneurysms, a number of devices and approaches have been developed. The following is a discussion summarizing the number of devices which have been developed and used in patients, as well as chosen the directions of this technology. The diversity of approach from an engineering and materials point of view speaks of the fact that opportunity exists for continued development in the future.

Endovascular aneurysm repair (EVAR) of abdominal aortic aneurysms has been challenged by a number of groups, and the shortcomings of this procedure have been documented in the scientific literature. However, patients and physicians continue to pursue this procedure as a viable means of treating abdominal aortic aneurysms. Both device evolution and advancement of technical skills have led to dramatic improvements in the outcomes of EVAR within the last decade. These improvements and accomplishments have also been chronicled in the literature. This review looks at the successes of EVAR, based on both US Food and Drug Administration trials and independent studies comparing conventional open repair and endovascular repair.