serted in the aortic arch during moderate hypothermic circulatory arrest and secured to the aortic wall with transfixing stitches.
This system has been further developed by using a traditional transfemoral artery stent grafting of the thoracic aorta65. In an effort to improve the closure of the distal false lumen, other combined endovascular-surgical approaches have been proposed (such as a transaortic stent-graft implantation into the descending aorta during ascending and aortic arch replacements)52,53. Both these series have reported an 80% clotting of preoperatively patent false lumen at six months follow-up. This combined surgical and endovascular procedure seems to be a feasible, reproducible, and effective alternative to an extended surgical aortic treatment. However, even though this double technique appears to be a highly valuable option for the future, it obviously needs further evaluation with defined indications and follow-up.
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