{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T12:14:57Z","timestamp":1791461697195,"version":"4.3.4"},"reference-count":15,"publisher":"SAGE Publications","issue":"5","license":[{"start":{"date-parts":[[2025,7,5]],"date-time":"2025-07-05T00:00:00Z","timestamp":1751673600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,7,5]],"date-time":"2025-07-05T00:00:00Z","timestamp":1751673600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["J Endovasc Ther"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:sec>\n                    <jats:title>Objective:<\/jats:title>\n                    <jats:p>This study evaluates the biomechanical performance and long-term durability of in situ laser fenestration (ISLF) compared to custom-made fenestrated endografts (CMD) using a controlled bench-top experimental setup.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>In situ, laser fenestration was performed in a RelayPro Dacron endograft using a 2.0\u2009mm Turbo Elite OTW Laser Atherectomy catheter. Ten BeGraft Bridging Stent-Grafts (BSG) were implanted in 5 ISLF and 5 CMD Zenith fenestrations and subjected to 50\u2009million fatigue cycles. Fenestrations were evaluated radiographically and microscopically for shape, size, fraying, endograft tearing, and BSG integrity.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      Fenestration areas (median 8.1\u2009mm\n                      <jats:sup>2<\/jats:sup>\n                      ) and axis lengths (median long axis: 4.03\u2009mm, median short axis: 2.33\u2009mm) in the ISLF group were significantly less than CMD fenestrations (median area: 24\u2009mm\n                      <jats:sup>2<\/jats:sup>\n                      ; median long axis: 5.83\u2009mm, median short axis: 5.8\u2009mm) immediately post-manufacturing (p=0.002), but increased significantly after stenting and fatigue (p=0.002). Tearing was observed in 3 of 5 ISLF after ballooning but resolved after BSG implantation. BSG integrity was superior in the ISLF group, with no all-layer defects, while 3 of the 5 tested BeGrafts used in the CMD group revealed fabric defects with partial fracture of the stent in 2 (p=0.007).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>ISLF fenestrations demonstrated comparable durability to CMD fenestrations after long-term fatigue testing, with distinct advantages in BSG integrity preservation. These findings support ISLF as a viable option for urgent treatment, although further research is warranted to validate these results.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Clinical Impact<\/jats:title>\n                    <jats:p>In-situ laser fenestration is a feasible technique for urgent complex aortic repair when customized or off-the-shelf devices are unavailable or technically unfeasible. However, long-term mechanical stability and durability under fatigue testing have not been previously evaluated. This study is the first to directly compare the long-term mechanical performance of industry-made custom fenestrations with in-situ laser fenestrations using a fatigue model. Results demonstrate non-inferiority of in-situ laser fenestrations, supporting their use as an effective off-label strategy for emergency or bailout interventions.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/15266028251350485","type":"journal-article","created":{"date-parts":[[2025,7,5]],"date-time":"2025-07-05T05:23:16Z","timestamp":1751692996000},"page":"2739-2745","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":3,"title":["Long-Term Experimental Evaluation of In Situ Laser-Fenestrated Versus Custom-Made Fenestrated Endografts"],"prefix":"10.1177","volume":"33","author":[{"ORCID":"https:\/\/orcid.org\/0009-0005-5600-2333","authenticated-orcid":false,"given":"Florian","family":"Elger","sequence":"first","affiliation":[{"name":"Department of Cardiac, Thoracic and Vascular Surgery, University Medical Center G\u00f6ttingen, G\u00f6ttingen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marcello","family":"Silvano","sequence":"additional","affiliation":[{"name":"Department of Cardiac, Thoracic and Vascular Surgery, University Medical Center G\u00f6ttingen, G\u00f6ttingen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Teodora Krasimirova","family":"Ormandzhieva","sequence":"additional","affiliation":[{"name":"Department of Cardiac, Thoracic and Vascular Surgery, University Medical Center G\u00f6ttingen, G\u00f6ttingen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ingo","family":"Kutschka","sequence":"additional","affiliation":[{"name":"Department of Cardiac, Thoracic and Vascular Surgery, University Medical Center G\u00f6ttingen, G\u00f6ttingen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7513-5063","authenticated-orcid":false,"given":"Giovanni Battista","family":"Torsello","sequence":"additional","affiliation":[{"name":"Department of Cardiac, Thoracic and Vascular Surgery, University Medical Center G\u00f6ttingen, G\u00f6ttingen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giovanni Federico","family":"Torsello","sequence":"additional","affiliation":[{"name":"Department of Radiology, University Medical Center G\u00f6ttingen, G\u00f6ttingen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2025,7,5]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1007\/BF02015271"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvs.2008.02.051"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1053\/j.semvascsurg.2023.04.004"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejvs.2018.05.014"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1177\/1526602821996724"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejvs.2023.08.060"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvir.2015.06.038"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejvs.2018.03.016"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejvs.2014.02.008"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1111\/aor.12777"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.1177\/1526602818772311"},{"key":"e_1_3_2_13_2","doi-asserted-by":"publisher","DOI":"10.1177\/1526602820947095"},{"key":"e_1_3_2_14_2","doi-asserted-by":"publisher","DOI":"10.1177\/1526602820981980"},{"key":"e_1_3_2_15_2","doi-asserted-by":"publisher","DOI":"10.1177\/15266028221119315"},{"key":"e_1_3_2_16_2","doi-asserted-by":"publisher","DOI":"10.3390\/jcm12154911"}],"container-title":["Journal 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