Surgeon modified Fenestrated EVAR: step by step procedure

This is a tutorial about performing on table standard EVAR fenestration and subsequent aneurysm repair in the present case the patient was unfit for surgery and had a large left accessory renal artery. He was treated with infrarenal surgeon modified endograft and accessory renal artery overstenting. Successful treatment and satisfying control CT scan



    Dr Luis Loureiro
    November 30, 2019

    Hi. Congratulations on the case.
    Why the polypropylene 6/0 constraints sutures?

    Dr Gioele Simonte
    December 3, 2019

    the circumferential suture serves just for the same porpoise of the reducing tie in the CM Cook grafts. once the graft is deployed it prevents justaposition with the aortic wall so the surgeon is able to rotate the device and adjust height.
    once the introducer sheat is secured inside the target vessel, ballooning the graft leads to suture rupture with proximal sealing

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