Endovascular Management of Aortic Arch Diseases: Current Status and Future Trends
10.1097/CD9.0000000000000080
- VernacularTitle:Endovascular Management of Aortic Arch Diseases: Current Status and Future Trends
- Author:
Chang SHU
1
;
Jiehua LI
;
Mingyao LUO
;
Quanming LI
;
Kun FANG
Author Information
1. State Key Laboratory of Cardiovascular Diseases, Center of Vascular Surgery, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Science and Peking Union Medical College, Beijing 100037, China
- Publication Type:Journal Article
- Keywords:
Aortic diseases;
Endovascular aortic arch repair;
Hybrid repair;
Chimney technique;
Fenestration technique;
Branched stent graft
- From:
Cardiology Discovery
2022;02(4):263-268
- CountryChina
- Language:English
-
Abstract:
Treatment of aortic arch (AA) diseases is challenging for surgeons. Conventional open surgery remains the "gold standard" but is associated with significant morbidity and mortality despite improvements in techniques. In the last 2 decades, thoracic endovascular aortic repair (TEVAR) has become the first-line treatment for diseases of the descending aorta, and its indications have expanded gradually. Various strategies have been proposed to preserve supra-aortic branches in TEVAR: hybrid technique, chimney technique, fenestration technique (including custom-made fenestrated or "scalloped" stent grafts, in situ fenestration, and physician-modified fenestration), and branched stent grafts. Though acceptable outcomes of endovascular aortic repair have been documented, the evidence regarding its long-term safety and efficacy is lacking, and concerns remain about the risk of cerebrovascular events, retrograde type-A dissection, endoleaks, and branch occlusion. This review discusses the current status and progress of endovascular repair of the AA, and looks toward future trends. We believe that multidisciplinary collaboration of a "HENDO" team (professionals in hybrid repair, endovascular repair, open surgery, cardiovascular anesthesia, and genetics) is essential for future repair of the AA to provide the optimal treatment.
