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Minimally Invasive Techniques for Total Aortic Arch Reconstruction.

Jason Faulds1, Harleen K Sandhu1, Anthony L Estrera1

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Endovascular techniques offer minimally invasive alternatives for aortic arch reconstruction, expanding treatment options beyond traditional open surgery. These advanced methods aim to improve patient outcomes and tolerance for complex aortic arch pathologies.

Keywords:
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Area of Science:

  • Vascular Surgery
  • Cardiovascular Interventions
  • Medical Device Technology

Background:

  • Endovascular aortic repair (EVAR) experience has grown for thoracic and infrarenal aorta.
  • Interest is increasing in endovascular aortic arch reconstruction due to its minimally invasive potential.

Purpose of the Study:

  • To review the evolving use of endovascular techniques for aortic arch pathology.
  • To assess the relevance of these techniques alongside established open aortic arch reconstruction.

Main Methods:

  • Discussion of minimally invasive alternatives to open total arch replacement.
  • Review of techniques including hybrid arch debranching, chimney/snorkel stent grafts, and branched endovascular devices.

Main Results:

  • Open total arch replacement is effective but requires cardiopulmonary bypass and circulatory arrest.
  • Minimally invasive endovascular approaches are being developed as alternatives for patient groups who may not tolerate open surgery.

Conclusions:

  • Endovascular techniques are emerging as viable options for aortic arch reconstruction.
  • The review considers the place of these new methods in the context of safe and durable open surgical repair.