In Situ Fenestration of Endovascular Grafts

In situ fenestration (ISF) refers to creation of a fenestration at a standard commercially available stent graft at the time of the procedure in order to preserve a target vessel. ISF represents an additional tool that can be considered to facilitate total endovascular repair of complex aortic pathologies involving supra-aortic or visceral vessels. ISF should therefore currently be reserved mainly for clinical scenarios and anatomies that cannot be treated either with custom-made devices or off-the-shelf devices for several reasons, or applied as a bailout procedure for unintentionally covered vital artery ostium during endovascular aortic repair.