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Introduction

It is known that complex aortic arch anatomy increases the technical difficulties of carotid stent procedures(CAS),1 and the risk of neurological complications,2 however data on the impact of arch anomalies on technical success and clinical outcome are sparse. Aortic arch anomalies are not infrequent in the population. Bovine arch, where the origin of the left commoncarotid artery is from the brachiocephalic trunk, is encountered in 10%.3,4 We have analyzed a group of patients with arch anomalies treated within our CAS program.