Exploring uncharted territory: A case series on endovascular thoracic stent grafting in unconventional clinical scenarios

Thoracic endovascular aortic repair is increasingly applied beyond standard instructions for use, driven by complex patient anatomy and clinical urgency. This case series presents three patients treated with off-label stent graft placement in the thoracic aorta. Each case required deviation from conventional instructions for use owing to anatomical or pathological challenges. By detailing these interventions, we aimed to illustrate the clinical decision-making involved in off-label thoracic endovascular aortic repair and to support a broader understanding of its role in managing complex aortic diseases.