Transcarotid Approach for Ascending Aortic Endovascular Repair.

This report describes a case of penetrating aortic ulcer in zone 0 of the ascending aorta with concern for free rupture that was treated with a transcarotid endovascular stent graft. The patient was noted to be a poor candidate for open repair given comorbidities, frailty, and age. She had chronic occlusion of the right external iliac artery and stenosis of the left external iliac artery. Endovascular ascending aortic stenting was deployed successfully through right common carotid access. The patient had an uncomplicated postoperative course without evidence of stroke. The transcarotid approach is an optimal alternative access for patients undergoing endovascular ascending aortic repair.