Endovascular repair of the aortic arch with the NEXUS Stent Graft System

To the Editor, Surgery of aortic arch diseases like aneurysms and dissections require invasive procedures that include cardiopulmonary bypass, selective cerebral perfusion, aortic cross-clamping, and hypothermic circulatory arrest.1 Unfortunately, a large number of these patients are considered non-eligible for open surgical repair and receive medical therapy only. The NEXUS Stent Graft System (Endospan Ltd., Israel) is indicated to treat high-risk surgical patients with ascending aorta and aortic arch diseases.2 This device received European CE mark approval back in March 2019 for the endovascular repair of aortic arch disease including both aneurysms and dissections requiring landing in the zone 0. The NEXUS Stent Graft System is a dual module device that is inserted through a 20-Fr delivery system. The integrated brachiocephalic artery branch avoids the possibility of branch separation and the interlocking latch mechanism avoids the migration or separation of the modules. This article describes the implantation of a NEXUS branched aortic stent graft system in Spain for the first time. Patient's written informed consent for publication was obtained. This is the case of a 75-years-old male patient with an enlarged downstream aorta 6 months after ascending aortic replacement with open distal anastomosis due to acute type A aortic dissection. The follow-up coronary computed...