{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,3]],"date-time":"2026-11-03T18:08:41Z","timestamp":1793729321646,"version":"4.6.1"},"reference-count":30,"publisher":"SAGE Publications","issue":"5","license":[{"start":{"date-parts":[[2025,11,7]],"date-time":"2025-11-07T00:00:00Z","timestamp":1762473600000},"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>To evaluate and compare outcomes of single- and double-fenestrated physician-modified endovascular grafts (PMEGs) for aortic arch pathologies treated in an emergent setting.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>All patients consecutively treated for an emergent aortic arch pathology were included in this retrospective single-center cohort study between July 2014 and March 2023. In each case, the distal smaller fenestration for the left subclavian artery (LSA) was the only 1 stented. For a double-fenestrated endograft, a proximal larger fenestration that incorporated both the brachiocephalic trunk and the left common carotid artery was added.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>A total of 86 patients with complicated aortic arch lesions were treated, with 74% being men and a mean age of 68 years. Of these, 63% underwent single LSA fenestration, while 37% had double-fenestrated thoracic endovascular aortic repair. The main indications for repair included acute complicated type B aortic dissection (TBAD) (54%), traumatic transection of the aorta (TTA) (19%), and other conditions such as penetrating aortic ulcer (PAU), degenerative aneurysm (DA), pseudoaneurysm (PSA), and aortic thrombus. The technical success rate was 91%, with modification times of 10 minutes for single fenestration and 23 minutes for double fenestration. Thirty-day mortality was 19%, with no significant difference between the 2 fenestration types. Neurologic events occurred in 3 patients (3%), and 3 (3%) patients had perioperative retrograde dissection. Endoleaks occurred in 5% (type 1) and 2% (type 3), with no type 2 endoleaks. Eight patients (9%) required reintervention, and all supra-aortic trunks remained patent. During a follow-up of 27.6 months, no patients experienced aortic rupture (AR), neurological events, or required conversion to open surgery.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Single and double PMEGs are suitable and reproducible treatment for emergent serious aortic arch lesions, with comparable outcomes whatever the aortic landing zone and number of fenestrations.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Clinical Impact<\/jats:title>\n                    <jats:p>Fenestrated physician-modified endovascular grafts for emergent aortic arch repair appear to be a promising treatment, offering reproducibility, rapid deployment, and limited manipulation of supra-aortic trunks. The standardized technique eliminates the need for complex sizing and benefits from consistent aortic arch anatomy in most patients. It provides clinicians with a practical and efficient option in emergency settings, achieving high technical success with acceptable complication rates.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/15266028251384226","type":"journal-article","created":{"date-parts":[[2025,11,7]],"date-time":"2025-11-07T10:03:42Z","timestamp":1762509822000},"page":"2332-2343","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":2,"title":["Single- and Double-Fenestrated Physician-Modified Stent Grafts for Emergent Aortic Arch Lesions"],"prefix":"10.1177","volume":"33","author":[{"ORCID":"https:\/\/orcid.org\/0009-0003-1818-4573","authenticated-orcid":false,"given":"Sanaa","family":"Kamel","sequence":"first","affiliation":[{"name":"Department of Thoracic and Vascular Surgery, Arnaud de Villeneuve Hospital, Montpellier, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robin","family":"Chastant","sequence":"additional","affiliation":[{"name":"Department of Thoracic and Vascular Surgery, Henri Duffaut Hospital, Avignon, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pierre","family":"Alric","sequence":"additional","affiliation":[{"name":"Department of Thoracic and Vascular Surgery, Arnaud de Villeneuve Hospital, Montpellier, France"},{"name":"PhyMedExp, Univ. 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Is total aortic arch replacement with the frozen elephant trunk procedure reasonable in elderly patients? Eur J Vasc Endovasc Surg. 2021;60(1):131\u2013137.","journal-title":"Eur J Vasc Endovasc Surg"},{"issue":"3","key":"e_1_3_2_14_2","first-page":"247","article-title":"A systematic review and meta-analysis of hybrid aortic arch replacement","volume":"2","author":"Moulakakis KG","year":"2013","unstructured":"Moulakakis KG, Mylonas SN, Markatis F, et al. A systematic review and meta-analysis of hybrid aortic arch replacement. 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