October 2009

CHIEF MEDICAL EDITOR'S PAGE Meeting the Thoracic Challenge? By Takao Ohki, MD, PhD, Chief Medical Editor

FEATURED TECHNOLOGY Endografts and the Aortic Arch: Zenith TX2 With Pro-Form Top 5 Viewed Control of endografts in the distal arch was difficult due to issues with conformability and accuracy—advances in graft technology may ensure a higher degree of technical success. By Matt Thompson, MD, FRCS; Ian Loftus, MD, FRCS; and Rob Morgan, MRCP, FRCR

CHALLENGING CASES Endograft Infection After EVAR An uncommon complication leads interventionists to opt for graft removal. By Jennifer A. Stableford, MD; Thomas S. Maldonado, MD; Todd Berland, MD;Billy Kim, MD; Mark A. Adelman, MD; H. Leon Pachter, MD; and Firas F. Mussa, MD

COVER STORY Partial Right Atrial Inflow Occlusion for TEVAR A novel technique for inducing controlled hypotension to facilitate endograft deployment during thoracic endovascular aortic repair. By W. Anthony Lee, MD

Snorkel Procedures for TEVAR Top 5 Viewed Two case studies demonstrate how this procedure ensures left carotid artery patency during thoracic endovascular aortic repair. By Grace J. Wang, MD, and Edward Y. Woo, MD

TEVAR via a Mini-Median Sternotomy Treating a descending thoracic aortic aneurysm after endovascular abdominal aortic aneurysm repair and compromised iliac artery access. By Ross Milner, MD, and Edward P. Chen, MD

Endograft Exclusion of Acute Descending Thoracic Aortic Dissection Top 5 Viewed The critical role of IVUS in this complicated presentation. By Rodney A. White, MD; Carlos E. Donayre, MD; Irwin Walot, MD; George Kopchok, BS; Arash Keyhani, DO; Omid Jazaeri, MD; and Joe Chauvapun, MD

IVUS-Directed Coil Embolization After Type B Aortic Dissection Top 5 Viewed False lumen thrombosis of a complicated dissection. By Taylor A. Smith, MD; Harshal S. Broker, MD; and Frank R. Arko, MD

Endovascular Repair of Blunt Aortic Injury Top 5 Viewed Do we have the right devices yet? By Benjamin W. Starnes, MD, FACS, and Gabriel Aldea, MD, FACS

FEATURED TECHNOLOGY Anatomical Fixation in Challenging Aortic Anatomies By Jeffrey P. Carpenter, MD; Mark J. Garcia, MD; Stuart A. Harlin, MD; Matthew T. Jung, MD; Zvonimir Krajcer, MD; and Julio A. Rodriguez-Lopez, MD

TODAY'S PRACTICE Business Divorce and Separating Medical Practices The many legal considerations that should be made to ensure a smooth separation among medical professionals. By Terrell J. Isselhard, JD

DEPARTMENTS Innovations

An Interview With Edward Y. Woo, MD A leading vascular surgeon from the Hospital of the University of Pennsylvania discusses an important study on malperfusion and rupture in complicated type B thoracic dissection. By Edward Y. Woo, MD