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In case of an isolated graft to the arch vessel, one should ensure sufficient space to inflate the endoclamp without compromising cerebral perfusion. If uncertain, one should consider cannulating the brachial or axillary artery to perfuse the brain during the endoclamp inflation.

Linear plication with external wrapping is a therapeutic option with promising mid-term results, in carefully selected, high surgical risk patients with an ascending aortic aneurysm.