Physician Modification of the TREO Stent Graft Using a Customized 3D-Printed Template (TREO FIT, Terumo Aortic, UK).
Daniel Becker, Christian Zielasek, Silvan Jungi et al.
✦ AI-curated · Sources linked
Case in brief
A patient with a 12 cm aneurysm and a type Ia endoleak 12 years after EVAR underwent repair using an off-the-shelf TREO aortic cuff modified into a three-fenestration physician-modified endovascular graft. A customized, sterilized 3D-printed silicone model of the patient’s reno-visceral aorta guided fenestration placement. The graft was deployed percutaneously, and covered bridging stents were placed in all three target vessels. Completion angiography and postoperative CT showed accurate graft positioning, patent vessels, and no type I or III endoleak.
What made this case unusual
A patient-specific 3D-printed silicone template was used to guide fenestration creation and placement in a physician-modified graft, rather than relying solely on conventional graft modification methods.
Diagnostic / clinical pearl
A patient-specific model of the reno-visceral aorta can facilitate precise fenestration placement when preparing a physician-modified endovascular graft.
Why it matters
The report identifies a practical limitation for further development: the template should better accommodate aortic kinking and angulation.