Abdominal & Thoracoabdominal Aorta
Physician-Modified Endovascular Graft (PMEG)
On-site customized stent-grafts when a manufactured device isn’t an option.
What it is
A PMEG is a stent-graft modified on-site to match the patient’s anatomy — an option for patients who don’t qualify for a commercially approved or custom-manufactured device, including those with urgent or symptomatic aneurysms who can’t wait for a custom device to be made. At the Center this is available through an FDA investigational study.
When it’s recommended
- Complex/thoracoabdominal aneurysms needing a tailored device
- Urgent or symptomatic aneurysms that cannot wait for manufacturing
- Patients ineligible for approved or custom devices
How it’s performed
Every plan is individualized and reviewed by our multidisciplinary aortic team.
Imaging-based planning of the required fenestrations/branches
The surgeon modifies the stent-graft on-site to fit the anatomy
The device is delivered endovascularly
Branch vessels are stented and the result confirmed
Recovery & follow-up
Similar to FB-EVAR — a minimally invasive recovery with a short hospital stay and ongoing surveillance imaging.
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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