Selective Supra-Aortic Trunk Stenting During Endovascular Total Aortic Arch Repair in Patients With Residual Chronic Type A Dissection Treated With Double-Fenestrated Physician-Modified Endografts

Double-fenestrated PMEGs are effective for treating residual cTAADs, with high SAT healing and favorable remodeling. Persistent SAT dissection may hinder remodeling and require additional intervention.Clinical ImpactAortic arch repair using fenestrated physician-modified endografts without systematic SAT stenting reduces SAT manipulation and may lower stroke risk, while promoting a high rate of SAT and aortic dissection healing. In cases where SAT dissection persists and aortic growth is reported, secondary complementary SAT intervention can be performed to enhance aortic remodeling.