TEVAR using a custom-made device for the treatment of a large PDA

Patent ductus arteriosus (PDA) is a prevalent congenital cardiovascular disorder that accounts for 5-10% of all cases of congenital heart disease. Using a non-touch exclusion technique in conjunction with thoracic endovascular aortic repair (TEVAR) may offer a viable alternative for treating PDA in high-risk complex patients. In a 27-year-old man complaining of exertional dyspnea and progressive fatigue, a large PDA, severe pulmonary valve regurgitation, and a significant enlargement of the pulmonary artery. There was a 20 mm PDA which originating from the descending aorta, and 7 mm distal to the orifice of the left subclavian artery (LSA). TEVAR was performed, using a custom-made Zenith Alpha Thoracic Endovascular Graft through the right common iliac artery.

[@maisamtaherian986]

Thank you very much for sharing this case. I have some questions. Would you please inform me:
1- what is the feature of your costume made device in comparison with regular stents? Is it just the sizing and tapering?
2- is it better to use a large occluder device for example large vascular plaque or even ASD device before deploying the cover stent to achieve a promising situation which guarantees no endoleak?

[@YaserJenabCardiologyInPractice]

Thanks. It is just size and tapering. Large occluders are alternative options with some risks of dislodgement.