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Ascending aortic pathology presents a unique challenge for treatment by thoracic endovascular aortic repair (TEVAR), because of lack of adequate endograft landing zones. This report describes a unique "reverse" extra-anatomical aortic arch debranching procedure performed to enable TEVAR of the ascending aorta.

Challenges of “Reverse” Aortic Arch Debranching for Repair of the Ascending Aorta by Thoracic Endovascular Aortic Repair