Anatomic features of the distal aortic arch that influence endovascular aneurysm repair

Optimal gantry angle correction should be the goal of any TEVAR procedure. Zone 2 seal zones require less gantry angulation than zone 3 seal zones by nearly 20°. This study shows that correction within 10° of optimal is unlikely to significantly impact successful seal and fixation for most patients. At 20°, however, substantial loss of seal zone can be expected. Measurements of the inner and outer curvature reveal different information about the distal arch and should be assessed individually. Zone 1 deployment rarely provides meaningful additional seal zone length.