title: Off-the-shelf fenestrated endografts: a realistic option for more than 70% of patients with juxtarenal aneurysms.
abstract: OBJECTIVE
  To evaluate the suitability of a standardized fenestrated endograft in patients with juxtarenal abdominal aortic aneurysms.
  
  
  METHODS
  High resolution computed tomographic angiograms from 100 consecutive patients (96 men; mean age 72 years) with juxta- (n = 78) and pararenal (n = 22) aneurysms treated electively between 2005 and 2010 with custom-made fenestrated endografts were reviewed. A centerline of flow reconstruction was carried out in a 3D imaging workstation to precisely define the aortic morphology, including aortic diameters and distances between visceral and renal arteries. The applicability of 2 different "off-the-shelf" standardized fenestrated endografts designed by the manufacturer was evaluated in this cohort. Both designs included 2 fenestrations for the renal arteries, 1 for the superior mesenteric artery (SMA), and a scallop for the celiac trunk. The designs differed in the lengths of the SMA to renal fenestration and renal to renal fenestration.
  
  
  RESULTS
  Endovascular treatment with one or both "off-the-shelf" endografts was deemed possible in 72 patients (56 with design 1, 52 with design 2, and 36 with both endografts). Of the 28 patients who were not candidates for a standardized fenestrated stent-graft of either design, the primary cause was a right renal artery that did not match the position of its corresponding fenestration.
  
  
  CONCLUSIONS
  Standardized fenestrated designs suitable for endovascular treatment of >70% of patients with juxta- and pararenal aneurysms currently treated with custom-made fenestrated endografts will soon be available. This new generation of endografts will permit rapid treatment of a large majority of patients requiring fenestrated endograft repair.
authors.affiliation: Vascular Surgery and 2Radiology, Hôpital Cardiologique, CHRU de Lille, France.
authors.forename: Jonathan
authors.initials: J
authors.lastname: Sobocinski
authors.forename: Guillerme
authors.initials: G
authors.lastname: d'Utra
authors.forename: Noel
authors.initials: N
authors.lastname: O'Brien
authors.forename: Marco
authors.initials: M
authors.lastname: Midulla
authors.forename: Blandine
authors.initials: B
authors.lastname: Maurel
authors.forename: Matthieu
authors.initials: M
authors.lastname: Guillou
authors.forename: Richard
authors.initials: R
authors.lastname: Azzaoui
authors.forename: Blayne
authors.initials: B
authors.lastname: Roeder
authors.forename: Timothy A
authors.initials: TA
authors.lastname: Resch
authors.forename: Stéphan
authors.initials: S
authors.lastname: Haulon
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D017544:Aortic Aneurysm, Abdominal / Q000000981:diagnostic imaging / Q000601:surgery*; D001027:Aortography / Q000379:methods; D001807:Blood Vessel Prosthesis; D019917:Blood Vessel Prosthesis Implantation / Q000295:instrumentation*; D057510:Endovascular Procedures / Q000295:instrumentation*; D005240:Feasibility Studies; D005260:Female; D005602:France; D006801:Humans; D021621:Imaging, Three-Dimensional; D008297:Male; D008875:Middle Aged; D061330:Multidetector Computed Tomography; D018579:Patient Selection; D011237:Predictive Value of Tests; D011474:Prosthesis Design; D011857:Radiographic Image Interpretation, Computer-Assisted; D012189:Retrospective Studies; D015607:Stents