title: Technical strategies to expand stent-graft applicability in the aortic arch and proximal descending thoracic aorta.
abstract: The endovascular repair of thoracic aortic pathology is on an evolutionary threshold, as advancing technologies and techniques combine to offer the interventionist expanded treatment opportunities. A variety of maneuvers are recommended to address the landing zone limitations to thoracic endografting imposed by the arch vessels: transostial bare stent placement, intentional occlusion of the arch vessel origin, vessel transposition, and bypass grafting. These adjunctive techniques can help us extend the option of a minimally invasive treatment to a greater number of patients with severe thoracic aortic lesions and comorbidities that place them at high risk for standard surgical intervention.
authors.affiliation: Center for Vascular Intervention, Union Memorial Hospital/MedStar Health, Baltimore, Maryland, USA. frankc@helix.org
authors.forename: Frank J
authors.initials: FJ
authors.lastname: Criado
authors.forename: Marcos F
authors.initials: MF
authors.lastname: Barnatan
authors.forename: Youssef
authors.initials: Y
authors.lastname: Rizk
authors.forename: Nancy S
authors.initials: NS
authors.lastname: Clark
authors.forename: Cecilia F
authors.initials: CF
authors.lastname: Wang
mesh_terms: D017545:Aortic Aneurysm, Thoracic / Q000601:surgery*; D019917:Blood Vessel Prosthesis Implantation; D006801:Humans; D015607:Stents