Tips and tricks to make the ascending aorta accessible to EVAR

Abstract

The ascending aorta is gaining increasing interest for endovascular specialists, as it opens the door to a potentially better way to treat aortic arch pathologies. Landing safely a stentgraft into the ascending aorta allows downgrading significantly the invasiveness of conventional open repair of the ascending aorta and/or aortic arch. Unfortunately, accessibility to the ascending aorta, in order to perform EVAR, can be challenging as the transfemoral approach might be cumbersome, or because the ascending aorta might not be appropriate for stentgraft landing. This paper will present some technical tips and tricks to achieve successful stentgraft landing in zone 0.