tional device exemption clinical trial (IDE #G130210, ClinicalTrials.gov: NCT0205011).Results: We performed 100 consecutive complex endovascular aortic aneurysm repairs (2011)(2012)(2013)(2014)(2015), using 58 (58%) commercially manufactured custom-made devices and 42 (42%) physician-modified devices to treat 4 (4%) common iliac, 42 (42%) juxtarenal, 18 (18%) pararenal, and 36 (36%) thoracoabdominal aneurysms (type 1, n ¼ 1; type 2, n ¼ 4; type 3, n ¼ 12; type 4, n ¼ 18; arch, n ¼ 1). Repairs included 309 fenestrations, branches, and scallops (average, 3.1 branch arteries/case). All patients had 30-day follow-up for 30-day event rates: mortality, three (3%); target artery occlusions, six (6%); progression to dialysis, five (5%); access complications, eight (8%); paraparesis, one (1%); bowel ischemia, one (1%); and no instances of myocardial infarction, paralysis, or stroke. Of 10 type I or type III endoleaks, 8 resolved (7 without intervention; 1 with secondary intervention). Median follow-up time was 563 days (interquartile range, 156-862). On 1-year Kaplan-Meier analysis (Figs 1 and 2), survival was 87%, freedom from type I or type III endoleak was 97%, target vessel patency was 92%, and freedom from aortic rupture was 100%. Average lengths of intensive care unit stay and inpatient stay were 1.4 days (standard deviation, 3.3) and 3.6 days (standard deviation 3.6), respectively.Conclusions: Complex aortic aneurysms can now be treated with minimally invasive fenestrated or branched endovascular repair. These shortterm outcomes are comparable or superior to those of historical cohorts of patients treated with open repair.
