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Manning BJ et al. – The authors describe a case of successful in situ fenestration of the left subclavian artery in a patient with an aortic arch aneurysm, treated with an endovascular stent graft. The authors outline a novel technique using through and through wire access and a pre–curved semi–rigid sheath, which allows successful access to the lumen of the aortic stent graft, despite an acute angle at the take–off of the LSA.

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