Gustavo S. Oderich, MD, FACS

Complex Aortic & Endovascular Surgery

Thoracic Aorta & Aortic Arch

Physician-Modified Graft (PMEG) — Arch / TBE Modification

On-site arch device modification for urgent or complex anatomy.

Overview

What it is

For arch disease, a stent-graft can be modified on-site — including thoracic branched (TBE) modifications — for patients who don’t qualify for, or can’t wait for, a manufactured device. This extends a minimally invasive option to complex and urgent arch cases.

When it’s recommended

  • Urgent or complex arch anatomy
  • Patients ineligible for an approved/custom arch device
  • Need for a tailored, on-site solution

How it’s performed

Every plan is individualized and reviewed by our multidisciplinary aortic team.

Imaging-based planning of branch positions

The surgeon modifies the device on-site

Endovascular delivery and branch stenting

Confirmation of brain/arm perfusion and seal

Recovery

Recovery & follow-up

Minimally invasive recovery with close surveillance imaging, individualized to the case.

Why the Baylor Medicine Center for Aortic Surgery

Complex aortic care is safest in experienced hands. Dr. Oderich and the Center bring more than 7,000 open and endovascular aortic repairs of experience, advanced imaging, and a multidisciplinary team to every case.

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