A Multi-arm, Multi-Center, Non-Randomized, Prospective, Clinical Study to Evaluate the Safety and Effectiveness of the NEXUS Aortic Arch Stent Graft System in Treating Thoracic Aortic Lesions Involving the Aortic Arch

• Male and female age ≥ 18.

• Proximal/ascending native or previously implanted surgical graft landing zone of appropriate length

• Proximal/ascending native or previously implanted surgical graft landing zone of appropriate diameter

• Distal/descending native landing zone of appropriate length

• Distal/descending native landing zone of appropriate diameter

• Brachiocephalic trunk native landing zone of appropriate length

• Brachiocephalic trunk native landing zone of appropriate diameter

• Appropriate take off angle between the Brachiocephalic Artery and the Aortic Arch perpendicular

• Appropriate aortic arch perpendicular diameter

• Chronic dissection with at least one of the following conditions:

• An aortic aneurysm with a maximum diameter ≥ 55 mm

• Rapidly expanding false lumen (growth of > 0.5 cm/6 months)

• Compressed true lumen associated with end organ malperfusion

• Symptomatic

• Aneurysm with at least one of the following conditions:

• Dilatation of the aortic arch larger than 5 cm in diameter for subject with fusiform aneurysm

• Dilatation of the aortic arch is 1.5 times the normal diameter for subjects ascending or descending

• Dilation of the aortic arch larger than 2.5 cm for subject with saccular aneurysm

• Symptomatic aneurysm of the aortic arch

• Aortic diameter growth rate > 5mm per 6 months

• Postoperative pseudoaneurysm expanding from anastomotic suture lines

• Penetrating aortic ulcer with at least one of the following:

• Symptomatic

• Ulcer demonstrates expansion

• Intramural hematoma with at least one of the following:

• Symptomatic (persistent pain)

• Transverse or longitudinal expansion on serial imaging

• In the event of a lesion in the ascending aortic, the proximal/ascending native or previously implanted surgical graft the landing zone must be appropriate

• Femoral / iliac artery diameter as documented by CTA or MRA that allows endovascular access to the diseased site with a 20 Fr. delivery catheter.

• Access vessels morphology suitable for endovascular repair in terms of tortuosity, calcification and angulation, documented by CTA/MRA.

• Brachial/Axial Artery diameter that allows endovascular access suitable for 7 Fr.

• Subject is considered an appropriate candidate for an elective surgery.

• Subject is considered to be at high risk for open repair, as determined by the investigator.

• Access vessels, iliac/femoral & brachial/axillary compatible with vascular access techniques (femoral cutdown or percutaneous), devices, and /or accessories.

• Subject is willing and able to comply with procedures specified in the protocol and is able to return for follow-up visits as specified by the protocol.