Various Endoluminal Approaches Available for Treating Pathologies of the Aortic Arch

Fig. 1. Published with permission from John Wiley and sons. “Ishimura classification of zones of the aortic arch: zone (Z) 0, ascending aorta to innominate artery; Z1, innominate artery to left common carotid artery; Z2, left common carotid artery to subclavian artery; Z3, left subclavian artery to proximal descending thoracic aorta”

Fig. 2. Hybrid arch repair. (A) Volume rendering frontal view of the aortic arch showing carotid-carotid cross over (arrow). (B) Neoinnominate surgical graft with bifurcation to the native innominate and left common carotid (arrowhead)

Fig. 3. Stented fenestration and scallop. (A) Axial maximum intensity projection showing saccular aneurysmal penetrating aortic ulcer (arrow) in zone 2. (B) Oblique sagittal view with the white cross at the proximal edge of the ulcer. (C) Oblique volume rendering image post-stented fenestration (white arrow) and scallop to the left common carotid artery (curved arrow)

Fig. 4. A patient with chronic type B aortic dissection treated with scallop stent graft (A) volume rendering oblique image showing aneurysmal dilatation, mainly at the distal arch level. (B) Maximum intensity projection showing the extent of the dissection which involves the origin of left subclavian artery (arrow). (C) Post-scallop stent graft insertion (curved arrow) with complete thrombosis of the false lumen down to the diaphragm level

Fig. 5. A schematic illustration of a scalloped/ fenestrated Relay ® (Terumo Aortic Bolton medical Inc.) endograft

Fig. 6. Branched arch stent graft. (A) Oblique sagittal maximum intensity projection of the aortic arch showing 6.5 cm saccular aneurysm involving the inner curvature of the aorta. (B) Volume rendering image post-double branch stent graft insertion

Fig. 7. A schematic illustration of a Relay ® (Terumo Aortic Bolton medical Inc.) branched endograft with inner branches

Fig. 8. Single chimney stent. (A) An elderly patient presented with symptomatic 6 cm saccular aneurysm in zone 2 ((white arrow). (B) Post-right carotid to left carotid bypass (arrowhead) and single chimney stent in the innominate artery (curved arrow) and TEVAR. The left subclavian artery was embolised with closure device