Coverage of the left subclavian artery is often necessary to establish an adequate landing zone in patients undergoing thoracic endovascular aortic repair,which can avoids endoleaks that contribute the important aspect of technical success of thoracic endovascular aortic repair.However,there have been controversial whether the routine revascularization of left subclavian artery benefits in preventing the complications in perioperative,like cerebrovascular accident,and which approach of revascularization should be taken for more advantages.In this review,the disputes have been discussed between the routine revascularization and selective revascularization of left subclavian artery based on clinic research published in recent years,and also introduce the progress in open surgery and endovascular technique of left subclavian artery revascularization.

Endovascular aortic arch repair remains challenging due to the complicated anatomy and the involved vital branches. Off-label techniques emerged during the last decade, including endografts with parallel stents (known as Chimney, Periscope, Sandwich), surgeon-modified endografts, and various other reported techniques. fenestration of standard endografts represents another off-label endovascular means to maintain perfusion to aortic side branches located in the excluded area. Its principle is based on fenestration of an endograft following its deployment inside the vascular system. As data are emerging regarding fenestration, the aim of this article is to review recent progress of technical descriptions, and clinic results of fenestration from the available literature.
Aorta, Thoracic ; surgery ; Blood Vessel Prosthesis Implantation ; Endovascular Procedures ; Prosthesis Design ; Stents ; Treatment Outcome