Evaluation of the Valiant Captivia Physician Fenestrated Stent Graft System in Aortic Arch and Descending Thoracic Aorta Pathologies

This study evaluates the Valiant Captivia Physician Fenestrated Stent Graft System — a custom-designed device for treating complex aortic arch problems including aneurysms, penetrating ulcers, and Type B aortic dissections — in patients who need urgent repair and cannot wait for a custom-made device. You may be eligible if: - You are 18 or older - You have a thoracic aortic aneurysm, penetrating aortic ulcer, or Type B aortic dissection requiring treatment - Your aortic anatomy meets specific sizing and structural requirements for the device - You are at high surgical risk and need semi-urgent repair - You are affiliated with the social security system You may NOT be eligible if: - Your arteries supplying the arms and brain are diseased, tortuous, or aneurysmal - You have severe aortic calcification, thrombus at sealing sites, or an ascending aorta larger than 40 mm - You have connective tissue disease (e.g., Marfan syndrome), active infection, mycotic aneurysm, or acute renal failure - You had a stroke or heart attack within the past 3 months - You have bleeding disorders, are pregnant, or have a life expectancy under 2 years - You are currently in another device or drug clinical trial Talk to your doctor to see if this trial is right for you.