Fenestrated endovascular grafts are the next generation of stent grafts used to repair aortic aneurysms. The addition of fenestrations, or holes, in the graft is a novel design that allows for stent branches into critical branches to the kidney and other viscera. These holes are prefabricated and customized for the patient based off of detailed CT scan measurements. Difficulty arises when clinicians attempt to use 2-D imaging to move a wire in 3-D space in order to place the “branch” stent into each of the branch vessels.Not only is this the single most time-consuming part of the procedure, keeping the patient in surgery longer and the surgeon from seeing other patients, it also significantly increases radiation exposure for both the patient and interventionalist and exposes the patient to increased risk of renal failure due to greater use of contrast agents. Fenestrated grafts are revolutionizing aortic aneurysm repair, but to fully realize their potential, an urgent need for a better placement system must be met.
