Evaluation of the Cook Custom Aortic Endograft, the Zenith t-Branch Endovascular Graft, and Surgeon-Modified Endograft in Treating Aortic Pathologies

This study evaluates specialized endovascular (minimally invasive, catheter-based) devices for treating complex aortic aneurysms and other serious aortic diseases — including aneurysms near the kidney arteries, in the chest, or involving the aortic arch. This approach is for patients who are considered too high risk for open surgery. You may be eligible if: - You are 18 years of age or older - You have an aortic or aortoiliac aneurysm meeting specific size or growth criteria - You have been assessed as high risk for standard open surgery - You are willing and able to comply with 5 years of follow-up - You have not had major surgery within the past 30 days You may NOT be eligible if: - You are under 18 years old - You are pregnant or breastfeeding - You have a life expectancy less than 12 months - You have an active infection or allergy to device materials (stainless steel, polyester, nitinol, gold) - You have severe kidney disease (eGFR < 30 and not on dialysis) - You have a mycotic (infectious) aortic aneurysm or aortic injury from trauma - You refuse blood transfusions Talk to your doctor to see if this trial is right for you.