Senémaud J, Fadel G, Touma J, et al. - This study was intended to present initial outcomes of physician modified stent grafts using antegrade laser fenestrations and image fusion guidance (LEVAR) and company manufactured custom-made (CM) stent-grafts for the treatment of complex abdominal aortic aneurysms, thoracoabdominal aortic aneurysms, and type I endoleaks. Researchers conducted a retrospective single centre study examining all LEVAR and Zenith (Cook) CM stent graft procedures between 1 January 2012 and 31 December 2018. The Kaplan–Meier method was used to calculate outcomes at 12 months. In this study, a total of 100 patients were included. The results demonstrate that LEVAR may provide satisfactory 12-month overall survival and target vessel patency rate in high-risk patients deemed unfit for open repair, though reported intra-operative adverse events, mortality, and re-interventions rates were high thus requiring close and extensive follow up.