Sealing of common iliac artery or abdominal aortic lesions as a complication of lumbar-disc surgery with a stent graft is effective and is suggested as an excellent alternative to open surgery for iatrogenic great-vessel injuries, particularly in critical conditions.

Compared with open repair, endovascular repair of traumatic thoracic aortic rupture is associated with a lower death rate but failed to reach statistical significance, most likely because of underpowering. These results prompt us to consider endovascular repair as the first-line therapy for acute traumatic rupture of the thoracic aorta, except in some rare but challenging anatomic situations. New stent-graft designs, sizes, and deployment systems could improve the results of endovascular repair in these indications.

The requirement for close conformability has influenced the design of next-generation devices. Manufacturers have modified devices and/or their deployment system to specifically address this problem. When compared with the results of our previous experimental test, this study demonstrates that these alterations have resulted in a marked improvement in the performance of commercially available stent graft systems.

Hybrid aortic arch repair by sequential transposition of the left common carotid artery and of the left subclavian artery for zone 1 lesions provides an attractive alternative for treating hemi-aortic arch lesions in high-risk patients with minimal atherosclerotic disease in the aorta and great vessels with acceptable primary results and encouraging midterm efficacy to prevent rupture. This hybrid strategy avoiding prosthetic bypass offers several advantages over conventional repair, including the potential to treat patients who are not candidates for open repair and single-stage treatment of some pathologic conditions previously requiring 2-stage repair.