1. “Real World” Thoracic Endografting: Results With the Gore TAG Device 2 Years After U.S. FDA Approval 
G. Chad Hughes, MD, Mani A. Daneshmand, MD, Madhav Swaminathan, MD, Jeffrey J. Nienaber, MD, Errol L. Bush, MD, Aatif H. Husain, MD, Walter G. Wolfe, MD, Richard L. McCann, MD 
The Annals of Thoracic Surgery 
Volume 86, Issue 5, Pages (November 2008)
DOI: /j.athoracsur
Copyright © 2008 The Society of Thoracic Surgeons Terms and Conditions

2. Fig 1
Three-dimensional computed tomography reconstruction of the aortic arch in a patient with a type B aortic dissection and the anatomic variant of the left vertebral artery arising directly from the aortic arch (arrow). In this anatomic situation, left arm ischemia typically results if the left subclavian artery is covered by the endograft, because the left vertebral (due to lack of anatomic contiguity) does not supply collateral flow to the arm. Adjunctive left carotid–subclavian bypass is performed at the time of endovascular repair if this anomaly is encountered.
The Annals of Thoracic Surgery  , DOI: ( /j.athoracsur )
Copyright © 2008 The Society of Thoracic Surgeons Terms and Conditions

3. Fig 2
Autopsy photograph from only patient in series in whom primary technical success was not achieved. The distal seal zone of the TAG graft (W. L. Gore and Associates, Flagstaff, AZ) is in an area of thrombus in aneurysm wall, which subsequently ruptured (metal probe in bottom right of photo), rather than in an area of nonaneurysmal aorta. Although no endoleak was seen on completion angiography, the distal seal zone is clearly in an area of thrombus, which confirms the recommendation in the device instructions for use that seal zones not contain excessive thrombus.
The Annals of Thoracic Surgery  , DOI: ( /j.athoracsur )
Copyright © 2008 The Society of Thoracic Surgeons Terms and Conditions

4. Fig 3
(A). A computed tomography scan demonstrates a proximal TAG graft (W. L. Gore and Associates, Flagstaff, AZ) collapse (arrow) 3 days after endovascular repair of a symptomatic penetrating atherosclerotic ulcer of the distal arch. (B) Intravascular ultrasound (IVUS) at the time of endovascular revision demonstrates a collapsed proximal graft, which has assumed a C-shaped configuration. (C). Intraoperative fluoroscopy after a Palmaz bare metal stent (Cordis Corp, Miami Lakes, FL) deployment within the proximal portion of the TAG graft. (D) IVUS confirms subsequent graft reexpansion.
The Annals of Thoracic Surgery  , DOI: ( /j.athoracsur )
Copyright © 2008 The Society of Thoracic Surgeons Terms and Conditions

5. Fig 4
Actuarial Kaplan-Meier overall (dotted line) and aorta-specific (solid line) midterm survival at 28 months after endovascular repair.
The Annals of Thoracic Surgery  , DOI: ( /j.athoracsur )
Copyright © 2008 The Society of Thoracic Surgeons Terms and Conditions

6. Fig 5
Autopsy photograph from the only late aortic-related death in the series. Note bare metal stent within the proximal aspect of the TAG graft (W. L. Gore and Associates, Flagstaff, AZ). This secondary procedure failed to seal the proximal type I endoleak on the inner curve of the aortic arch (denoted by location of the yellow probe), and the patient subsequently died of aortic rupture into her left lung.
The Annals of Thoracic Surgery  , DOI: ( /j.athoracsur )
Copyright © 2008 The Society of Thoracic Surgeons Terms and Conditions

7. Fig 6
(A) Intraoperative photograph shows TAG grafts (W. L. Gore and Associates, Flagstaff, AZ) being removed from a chronically dissected descending thoracic aorta with secondary aneurysm during a period of deep hypothermic circulatory arrest. (B) Photograph of the explanted devices. (C) Intraoperative photograph of completed open descending aortic replacement. The proximal anastomosis to the distal arch was performed under deep hypothermic circulatory arrest; perfusion to the upper body was then resumed via the graft sidearm (seen in bottom left of the photograph). The distal anastomosis was performed in an open manner during rewarming with the graft clamped below the sidearm, which was later oversewn and removed.
The Annals of Thoracic Surgery  , DOI: ( /j.athoracsur )
Copyright © 2008 The Society of Thoracic Surgeons Terms and Conditions