The Particulars: Among patients with an inadequate proximal landing zone and/or severe angles complex configuration, an endograft fabricated based on preoperative three-dimensional CT images may allow for the simplification of aortic arch repair.

Data Breakdown: Japanese researchers used endografts designed to be similar to the aortic arch configuration of patients who required stent-graft landing in the aortic arch. Rotation was controlled by the device’s pre-curved shape. Technical and initial successes were observed in 455 and 434 patients, respectively. Average operative and fluoroscopic times were 161 and 26 minutes, respectively. Strokes, permanent paralysis, and perioperative death were identified as factors that complicated procedures.

Take Home Pearl: Use of a pre-curved fenestrated endograft appears to simplify the repair of aortic arch disease while minimizing the risk of operative complications.