{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,19]],"date-time":"2026-03-19T03:41:19Z","timestamp":1773891679988,"version":"3.50.1"},"reference-count":24,"publisher":"Georg Thieme Verlag KG","issue":"01","license":[{"start":{"date-parts":[[2022,5,31]],"date-time":"2022-05-31T00:00:00Z","timestamp":1653955200000},"content-version":"vor","delay-in-days":119,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Aorta (Stamford)"],"published-print":{"date-parts":[[2022,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>\n          Objective\u2003This study aims to describe our technique and early experience with physician-modified endovascular grafts (PMEGs) for aortic arch diseases in zone 2. We used a total endovascular technique based on a single fenestrated endograft to preserve left subclavian artery (LSA) patency.<\/jats:p><jats:p>\n          Methods\u2003From December 2019 to August 2020, six consecutive patients with a variety of thoracic aortic diseases were treated with handmade fenestrated thoracic aortic grafts: four aortic dissections, one penetrating aortic ulcer, and one intramural hematoma. The planning, endograft modification, surgical technique, and follow-up of the patients were described. We evaluated immediate technical success and after 30 days, the LSA patency, Type-1 endoleak, and postoperative complications.<\/jats:p><jats:p>\n          Results\u2003Thoracic endovascular aortic repair (TEVAR) was performed for zone 2 in all cases. Immediate technical success, defined as successful alignment of the LSA with a covered stent and no Type-1 endoleak, was achieved in all cases. Patients had a 30-day follow-up computed tomography, which demonstrated LSA patency and no Type-I endoleaks. To date, no strokes, left arm ischemia, paraplegia, or conversions to open surgery have been reported; one patient operated for acute Type B dissection died during the early follow-up.<\/jats:p><jats:p>\n          Conclusion\u2003TEVAR for zone 2 with a PMEG to maintain LSA patency achieved technical success and early durability. It is expected that with longer follow-up and a larger number of cases, these results will be confirmed.<\/jats:p>","DOI":"10.1055\/s-0042-1742696","type":"journal-article","created":{"date-parts":[[2022,5,31]],"date-time":"2022-05-31T22:30:26Z","timestamp":1654036226000},"page":"013-019","source":"Crossref","is-referenced-by-count":10,"title":["Physician-Modified Endovascular Grafts for Zone-2 Thoracic Endovascular Aortic Repair"],"prefix":"10.1055","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2757-340X","authenticated-orcid":false,"given":"Andr\u00e9 B.","family":"Queiroz","sequence":"additional","affiliation":[{"name":"Centro de Doen\u00e7as da Aorta - CDA, Division of Vascular and Endovascular Surgery, Cardiac Surgery, Cardiology and Anesthesia, Universidade Federal da Bahia, Hospital Ana Nery, Salvador-Bahia, Brazil"},{"name":"Division of Vascular Surgery, Universidade Federal da Bahia, Hospital Universit\u00e1rio Professor Edgar Santos, Salvador-Bahia, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jackson B.","family":"Lopes","sequence":"additional","affiliation":[{"name":"Centro de Doen\u00e7as da Aorta - CDA, Division of Vascular and Endovascular Surgery, Cardiac Surgery, Cardiology and Anesthesia, Universidade Federal da Bahia, Hospital Ana Nery, Salvador-Bahia, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vanessa P.","family":"Santos","sequence":"additional","affiliation":[{"name":"Division of Vascular Surgery, Universidade Federal da Bahia, Hospital Universit\u00e1rio Professor Edgar Santos, Salvador-Bahia, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pedro B. A. F.","family":"Cruz","sequence":"additional","affiliation":[{"name":"Centro de Doen\u00e7as da Aorta - CDA, Division of Vascular and Endovascular Surgery, Cardiac Surgery, Cardiology and Anesthesia, Universidade Federal da Bahia, Hospital Ana Nery, Salvador-Bahia, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ronald J. R.","family":"Fidelis","sequence":"additional","affiliation":[{"name":"Division of Vascular Surgery, Universidade Federal da Bahia, Hospital Universit\u00e1rio Professor Edgar Santos, Salvador-Bahia, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jos\u00e9 S. Ara\u00fajo","family":"Filho","sequence":"additional","affiliation":[{"name":"Centro de Doen\u00e7as da Aorta - CDA, Division of Vascular and Endovascular Surgery, Cardiac Surgery, Cardiology and Anesthesia, Universidade Federal da Bahia, Hospital Ana Nery, Salvador-Bahia, Brazil"},{"name":"Division of Vascular Surgery, Universidade Federal da Bahia, Hospital Universit\u00e1rio Professor Edgar Santos, Salvador-Bahia, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Luiz C. S.","family":"Passos","sequence":"additional","affiliation":[{"name":"Centro de Doen\u00e7as da Aorta - CDA, Division of Vascular and Endovascular Surgery, Cardiac Surgery, Cardiology and Anesthesia, Universidade Federal da Bahia, Hospital Ana Nery, Salvador-Bahia, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2022,5,31]]},"reference":[{"issue":"05","key":"ref1","doi-asserted-by":"crossref","first-page":"605","DOI":"10.1016\/j.ejvs.2018.02.006","article-title":"ESVS Volodos lecture: innovations and the Hippocratic oath","volume":"55","author":"P Gloviczki","year":"2018","journal-title":"Eur J Vasc Endovasc Surg"},{"issue":"04","key":"ref2","doi-asserted-by":"crossref","first-page":"1195","DOI":"10.1016\/j.athoracsur.2007.04.128","article-title":"Risk factors for perioperative stroke after thoracic endovascular aortic repair","volume":"84","author":"J T Gutsche","year":"2007","journal-title":"Ann Thorac 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