title: Custom fenestration templates for endovascular repair of juxtarenal aortic aneurysms.
abstract: Physician-modified endovascular grafts, with fenestrations added to accommodate major branch vessels, provide a means for endovascular treatment of abdominal aortic aneurysms that are adjacent to the renal arteries. Manual measurements of vessel origin locations from computed tomography images, however, take time and can lead to errors in the positions of the fenestrations. To make the fenestration process faster and more accurate, we have developed a procedure to create custom templates that serve as patient-specific guides for graft fenestration. We use a three-dimensional printer to create a clear rigid sleeve that replicates the patient's aorta and includes holes placed precisely at the locations of the branch vessels. The sleeve is slipped over the graft, the locations of the openings are marked with a pen, and the fenestrations are created after the sleeve is removed. Custom fenestration templates can potentially save procedural costs and make minimally invasive aortic aneurysm repair available to more patients.
authors: Applied Physics Laboratory, University of Washington, Seattle, Wash. Electronic address: leotta@u.washington.edu.
authors: Daniel F
authors: DF
authors: Leotta
authors: Division of Vascular Surgery, Department of Surgery, University of Washington, Seattle, Wash.
authors: Benjamin W
authors: BW
authors: Starnes
mesh_terms: D001012:Aorta, Abdominal / Q000000981:diagnostic imaging / Q000601:surgery*; D017544:Aortic Aneurysm, Abdominal / Q000000981:diagnostic imaging / Q000601:surgery*; D001027:Aortography / Q000379:methods; D001807:Blood Vessel Prosthesis; D019917:Blood Vessel Prosthesis Implantation / Q000295:instrumentation*; D003198:Computer Simulation; D017076:Computer-Aided Design; D057510:Endovascular Procedures / Q000295:instrumentation*; D006801:Humans; D021621:Imaging, Three-Dimensional; D008955:Models, Cardiovascular; D066330:Printing, Three-Dimensional; D011474:Prosthesis Design; D011857:Radiographic Image Interpretation, Computer-Assisted; D012984:Software; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome