Abstract
Any stent graft intended for use in the aortic arch has to accommodate variation in the shape, size, position, and orientation of the ascending thoracic aorta, the descending thoracic aorta, and the supra-aortic trunks. In theory, each variable adds an entire dimension to a complex matrix of possible stent graft designs. In practice, it is often possible to mix and match relatively simple modular components during in situ stent graft assembly to achieve a form of intraoperative customization. This modular approach has proved to be successful in the thoracoabdominal aorta, in which (for more than a decade) a single “off-the-shelf” branched stent graft (t-Branch; Cook Medical, Bloomington, Ind) has been combined with a variety of branches, proximal extensions, and distal extensions in elective and urgent circumstances.
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