Frontiers in Medicine
Clinically silent early proximal seal failure with suspected interval distal endograft displacement after hybrid zone 2 thoracic endovascular aortic repair in severe arch tortuosity: a case report with 1-year follow-up
Background Durable hybrid zone 2 thoracic endovascular aortic repair depends on adequate healthy sealing length, appropriate oversizing, and close endograft apposition. Severe arch tortuosity can compromise these requirements even when completion angiography is satisfactory. Case presentation A 46-year-old woman with a primary non-post-surgical distal arch and proximal descending thoracic aneurysm underwent left carotid-subclavian bypass, left subclavian artery origin occlusion, and zone 2 thoracic endovascular aor …