Endovascular approach to acute aortic trauma

Table 1 Anatomic considerations

Anatomical features to consider	Implications
Diameter of proximal and distal landing zones	Determines size of endograft that can/should be utilized
Distance from lesion to origin of left subclavian artery	Will obtaining an adequate landing zone require coverage of the left subclavian artery?
Distance from lesion to origin of left common carotid artery	If required, is there room to land distal to the origin of the left common carotid artery? Will there be room, if needed, to clamp distal to the origin or will circulatory arrest be needed if subsequent operative repair is needed?
Degree of curvature across the proximal landing zone	Is there a high likelihood that to avoid malposition along the inner curvature that the graft will have to placed more proximally?
Quality of the aorta	Is there significant thrombus and/or calcification that would pose a risk of stroke or Type I endoleak?
Quality of access vessels	Is the diameter sufficient to permit the required sheath? Are there more proximal calcifications and/or tortuosity that might prevent safe passage of the sheath?
Distance from proposed access vessel to the lesion	Does the system being used have sufficient length to reach the proposed site?
Length of the injury	If using cuffs, how many may be required to ensure fixation
Vascular anomalies	Anomalous origin of left vertebral artery? Patent LIMA graft? Aberrant origin of right subclavian artery?