Figure 2. Intraoperative details. (A) A wrapped artificial blood vessel ring of about 6 cm long and 12.5 cm in circumference is placed around the ascending aorta, with the wire marker (red arrow) identifying its location. (B) A long sheath soft core was inserted into the ascending aorta through the right common carotid artery puncture point (red arrow indicates the position of the wire marker under X-ray). (C) Two large vessel-covered stents were deployed. (D) The fenestration via the left common carotid artery is shown. (E) Pre-dilatation was performed using 4-mm and 8-mm balloons through the left common carotid artery. (F) A balloon-expansible Express LD 10×37 mm stent was deployed. (G) The fenestration via the brachiocephalic artery is shown. (H) Pre-dilation was performed using 5-mm and 10-mm balloons through the brachiocephalic artery. (I) The fenestration via the left subclavian artery is shown. (J) Post-deployment angiography is shown. These images are original and were obtained from intraoperative digital subtraction angiography without any special post-processing.