Post by Miroslav Paripovic, MD, FEBVS

A successful endovascular treatment of a challenging Zone 3 penetrating aortic ulcer (PAU) with complex arch morphology. After careful case planning, using a stent graft of #Medira_Aortic with #Tianyi_Gewebe, we opted for in situ fenestration to preserve perfusion of the left subclavian artery, followed by implantation of a #BeGraft stent. The entire procedure was performed percutaneously, avoiding surgical exposure and demonstrating the potential of advanced endovascular strategies in complex thoracic aortic pathology. This case highlights the importance of meticulous planning, technical expertise, and seamless multidisciplinary collaboration in achieving an excellent outcome. Special thanks to: Roman Priv.Doz.Dr Gottardi MBA,FEBCTS our Head of Department of Cardiac, Thorax and Vascular Surgery at Westpfalz-Klinikum Many thanks to: • Jan Ulmer and #Team for their outstanding technical support throughout the procedure. • All members of the #hybrid_OR_team for their dedication and professionalism. Westpfalz-Klinikum MEDIRA Aortic Jan Ulmer Max Bogenschütz Deutsche Gesellschaft für Gefäßchirurgie und Gefäßmedizin e. V. (DGG) Journal of Vascular Surgery ESVS - European Society for Vascular Surgery Aortic Association Aortic Dissection Collaborative International Vascular Surgery Association (IVSA)