“…193 To minimize the risk of stroke, temporary carotid artery occlusion, filter placement and carbon dioxide flushing of the delivery system have been proposed. 193,194,200 For endovascular aortic arch repair, there are 2 general graft designs: fenestrated and branched arch endografts. Both designs are currently available as custom-made devices only, so a manufacturing time of between 4 and 8 weeks precludes their use in urgent and emergency situations.…”