Developing a complex endovascular fenestrated and branched aortic program.
Andres Schanzer, Donald Baril, William P Robinson...
https://pubmed.ncbi.nlm.nih.gov/25595400/Actively Recruiting
Led by Andres Schanzer · Updated on 2025-10-22
600
Participants Needed
1
Research Sites
N/A
Total Duration
Researchers are evaluating the safety and effectiveness of custom-made devices, Zenith t-Branch devices, and physician-modified FDA-approved endovascular grafts for treating patients with complex aortic aneurysms, including abdominal, aortoiliac, thoracoabdominal, and aortic arch aneurysms. This study includes patients whose anatomy is unsuitable for currently marketed grafts in the United States, those who cannot wait for commercial device manufacturing, and those at high risk for open surgical repair. The study also includes patients with connective tissue diseases such as Marfan, Ehlers-Danlos, or Loeys-Dietz syndromes. The treatments involve custom-made fenestrated or branched stent grafts that are tailored to the patients anatomy by adding small holes fenestrations to allow blood flow to critical organs like the kidneys, liver, and intestines. Depending on the patients urgency and anatomy, repair is done with a custom-made device, a Zenith t-Branch device, or a physician-modified device. The device is inserted through small incisions in the groin or upper arm, and stents are placed through the graft fenestrations into affected blood vessels to maintain blood flow. Participants will be monitored over time to assess the success of the treatment and any major adverse events within 30 days of the procedure. Follow-up will continue for five years to evaluate long-term outcomes. Researchers will use imaging and clinical assessments to track treatment effectiveness, focusing on the proportion of patients achieving treatment success 12 months after the procedure. Safety and adverse events will also be closely monitored throughout the study.
CONDITIONS
Complex Aortic Aneurysm Repair Using Physician Modified Endografts and Custom Made Devices
S
Shauneen Valliere, MSN, NP
A
Andres Schanzer, MD
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Andres Schanzer
Lead Sponsor
This table compares participation in this trial with other options available for this condition. The information is drawn from published research and the trial’s study details and is provided for educational purposes only.
| Factors | Custom/Modified Endovascular Stent Graft | Open Surgical Repair (Current Care) |
|---|---|---|
| What it is | A minimally invasive procedure using custom-made or physician-modified fenestrated and branched stent grafts placed endovascularly to repair complex aortic aneurysms. Grafts are tailored to each patient’s anatomy, including fenestrations for blood flow to vital organs. | An open surgical procedure involving direct repair of the aorta, often with graft replacement. Requires a large incision and clamping of the aorta, generally reserved for patients fit for major surgery. |
| Primary use | Repair of thoracoabdominal, pararenal, juxtarenal, arch, and syndromic aortic aneurysms in patients with high surgical risk or unsuitable anatomy for standard endovascular devices. | Definitive repair of complex aortic aneurysms in patients suitable for major open abdominal or thoracic surgery, typically when anatomy does not permit standard endovascular grafting. |
| How it is given or performed | Surgeons introduce stent grafts via small incisions in the groin or upper arm, modifying devices with fenestrations for blood vessels to key organs. Additional stents are placed through fenestrations as needed. | Aorta is accessed through a large incision, clamped, and repaired or replaced with a surgical graft. Blood flow to organs is temporarily interrupted; procedure generally requires intensive postoperative care. |
| Evidence status | Prospective multicenter studies report patient survival and procedure-related outcomes for fenestrated/branched endovascular repair, but longer-term evidence is still emerging and outcomes depend on patient risk and anatomy. | Open repair has established long-term outcomes and durability in suitable patients, but carries higher risk of perioperative complications and mortality, especially in high-risk groups. |
| Important limitations | Endovascular repair may be limited by patient anatomy, device suitability, and procedural complexity. Complications include spinal cord injury, acute kidney injury, and need for long-term follow-up. Not all patients are eligible, and technical demands are significant. | Open surgery requires higher physical fitness, extensive recovery, and carries increased perioperative risk. Some patients cannot tolerate surgery due to comorbidities; anatomical complexity makes procedures technically demanding. |
Disclaimer: This comparison is created with the help of artificial intelligence(AI) and may contain errors or missing information. It is not medical advice and does not mean one option is better or safer than another. Clinical trials are still being studied, and joining a trial is your choice. Please consult your healthcare professional before making any decisions.
You may qualify if you...
You will not qualify if you...
Duration - 2 to 4 weeks
Participants are screened for eligibility to participate in the trial.
1 visit (in-person)
Duration - Up to 8 weeks until repair for non-urgent patients; urgent patients receive treatment as soon as possible
Participants undergo endovascular repair of complex aortic aneurysms using a custom made fenestrated or branched stent graft, a t-Branch device, or a physician modified stent graft. The device is inserted through small incisions in the groin (and sometimes upper arm) to maintain blood flow to critical organs.
1 procedure visit (in-person)
Duration - Up to 5 years
Participants are monitored for treatment success and any major adverse events after the procedure, with follow-up continuing for up to 5 years to assess long-term outcomes.
Multiple follow-up visits over 5 years
Study Type
INTERVENTIONAL
Masking
NONE
Allocation
NA
Model
SINGLE_GROUP
Primary Purpose
TREATMENT
Number of Arms
1
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https://pubmed.ncbi.nlm.nih.gov/38989575/Andres Schanzer
Lead Sponsor