{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T04:50:26Z","timestamp":1787028626823,"version":"build-2736575974"},"reference-count":22,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2022,4,13]],"date-time":"2022-04-13T00:00:00Z","timestamp":1649808000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>The goal of this study was to describe the surgical results of physician-modified endografts (PMEG) utilizing a 3D aortic template in a center with no prior experience in complex endovascular aortic repairs. Forty-three patients underwent physician-modified graft stent implantation using a 3D aortic model. The inclusion criteria were juxtarenal and suprarenal aortic aneurysms, type IV thoracoabdominal aneurysms, and type IA endoleak after endovascular aortic repair. In asymptomatic patients, the diameter threshold for aneurysm repair was 5.5 cm in males and 5.0 cm in females. 3D aortic templates were prepared from the patient\u2019s computed tomography angiography scans and sterilized before use in the operating suite. Forty-three stent grafts were modified with the use of a 3D printing template. A total of 162 reinforced fenestrations (37 celiac, 43 right renal, 39 left renal, 43 superior mesenteric) with a mean of 3.8 per patient were performed. All PMEGs had a posterior reducing-diameter tie and a preloaded guidewire. The mean modification time was 86 \u00b1 12 min. The mean follow-up was 14 \u00b1 12 months. The 30-day mortality was 12%. During the follow-up period, the patency rate was 95% per the superior mesenteric artery, 93% per right renal artery, 95% per left renal artery, and 89% per celiac trunk. Twelve (28%) patients had endoleak, of which type I or III was present in 5 (12%) patients, and type II in 7 (16%). 3D printing can be successfully integrated into the physician\u2019s everyday practice of stent graft modification. However, the use of this approach in centers without experience performing complex aortic procedures results in worse surgical metrics than those previously reported.<\/jats:p>","DOI":"10.3390\/jcm11082180","type":"journal-article","created":{"date-parts":[[2022,4,13]],"date-time":"2022-04-13T21:33:42Z","timestamp":1649885622000},"page":"2180","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":22,"title":["Initial Experience with Fenestrated Physician-Modified Stent Grafts Using 3D Aortic Templates"],"prefix":"10.3390","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3365-1822","authenticated-orcid":false,"given":"Pawe\u0142","family":"Rynio","sequence":"first","affiliation":[{"name":"Department of Vascular Surgery, Pomeranian Medical University in Szczecin, 70-111 Szczecin, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tomasz","family":"Jedrzejczak","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery, Pomeranian Medical University in Szczecin, 70-111 Szczecin, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anita","family":"Rybicka","sequence":"additional","affiliation":[{"name":"Department of Nursing and Health Sciences, Pomeranian Medical University, 71-210 Szczecin, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ross","family":"Milner","sequence":"additional","affiliation":[{"name":"Center for Aortic Diseases, Chicago, IL 60637, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Piotr","family":"Gutowski","sequence":"additional","affiliation":[{"name":"Department of Vascular Surgery, Pomeranian Medical University in Szczecin, 70-111 Szczecin, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6670-927X","authenticated-orcid":false,"given":"Arkadiusz","family":"Kazimierczak","sequence":"additional","affiliation":[{"name":"Department of Vascular Surgery, Pomeranian Medical University in Szczecin, 70-111 Szczecin, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,4,13]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1201","DOI":"10.1016\/j.jvs.2015.10.099","article-title":"A propensity-matched comparison for endovascular and open repair of thoracoabdominal aortic aneurysms","volume":"63","author":"Ferrer","year":"2016","journal-title":"J. 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