Surgical elastase-induced aneurysm creation. A, The right common carotid (black arrow), subclavian (white arrow), and brachiocephalic arteries are encircled with ligatures. B, Under temporary clip occlusion, elastase is injected into the lumen and adventitia of the carotid (both models) and subclavian arteries (fusiform model only). C, A 3F Fogarty balloon catheter is introduced into the carotid artery for angioplasty. D, The distal right carotid artery is occluded, and clips are removed.