PhD Scientific Days 2025

Poster Session I. - T: Cardiovascular Medicine and Research

A Planning Software for Physician-Modified Endografts: Improving Precision and Speed

Name of the presenter

Juhos Bendegúz

Institute/workplace of the presenter

Semmelweis Aortic Center, Department of Interventional Radiology, Heart and Vascular Centre, Semmelweis University, Budapest, Hungary

Authors

Bendegúz Juhos¹, András Szentiványi MD¹, Csaba Csobay-Novák MD, PhD¹

1: Semmelweis Aortic Center, Department of Interventional Radiology, Heart and Vascular Centre, Semmelweis University, Budapest, Hungary

Text of the abstract

Introduction

Fenestrated endovascular aneurysm repair (FEVAR) is the preferred endovascular treatment for juxtarenal complex abdominal aortic aneurysms (CAAAs). In urgent clinical settings, physician-modified endografts (PMEGs) offer a viable alternative to custom-made devices due to their immediate availability. Although 3D-printed models aid in accurate fenestration placement, their production is time-consuming. The developed punch card technique has emerged to streamline this process. However, automated planning tools have been largely unavailable until now. The present study evaluates a newly developed software designed to automate punch card creation and optimize planning efficiency.

Aims

The aim of this study was to evaluate and present the performance of a custom-developed software tool designed to automate fenestration positioning on punch cards based on longitudinal and circumferential reference data, and to compare its planning efficiency and accuracy to the conventional manual method.

Method

A retrospective, single-center bench-top study was conducted using data from elective FEVAR cases performed between May 2023 and September 2024. Punch card planning was performed using both manual and software-assisted methods. Time to completion and the accuracy of fenestration placement were recorded and compared, with errors measured in both longitudinal and circumferential dimensions.

Results

A total of 76 punch cards and 288 fenestrations were evaluated. Software-assisted planning significantly reduced preparation time (manual: 233.0 ± 40.3 s vs. software: 63.2 ± 21.5 s; p < .0001). Positional inaccuracies were consistently lower in the software group across all major visceral artery fenestrations. No significant difference in completion time was observed across the software learning curve.

Conclusion

Software-assisted punch card planning for PMEG procedures offers considerable improvements in speed and positional accuracy compared to manual planning. This streamlined workflow may reduce planning time and potential error, benefiting both clinical outcomes and resource efficiency.

Funding

Supported by the 2024-2.1.2-EKÖP-KDP-2024-00002 University Research Scholarship Programme of the Ministry for Culture and Innovation from the source of the National Research, Development and Innovation fund of Hungary.