What revascularization techniques may be required when an endoprosthesis is placed proximal to the left subclavian artery involving the innominate, common carotid, and/or subclavian arteries?
When the endoprosthesis is placed proximal to the left subclavian artery, the innominate, common carotid, and/or subclavian arteries may require revascularization through open surgical or endovascular techniques. Open surgical treatment may be performed as a bypass (eg, debranching) or transposition procedure. Endovascular revascularization may also be accomplished through separate parallel stent graft(s) extending alongside the aortic tube stent graft into a brachiocephalic vessel(s). Alternatively, a fenestrated and/or branched endograft multipiece (modular) system may be implanted, which involves an aortic tube device that has a fenestration through which an additional stent-graft extension(s) is placed into a brachiocephalic vessel as needed.
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