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Endovascular total arch replacement techniques and early results.
Vladimir Makaloski1, Nikolaos Tsilimparis1, Fiona Rohlffs1
1Department of Vascular Medicine, German Aortic Center, University Heart Center Hamburg-Eppendorf, Hamburg, Germany.
Annals of Cardiothoracic Surgery
|August 30, 2018
Summary
Endovascular aortic arch repair offers promising early results using techniques like custom stent-grafts. Further studies are needed to confirm long-term safety and efficacy of these complex thoracic aortic procedures.
Area of Science:
- Vascular Surgery
- Cardiovascular Research
- Medical Technology Innovation
Background:
- Thoracic endovascular aortic repair (TEVAR) has gained prominence over two decades for various aortic diseases.
- Total endovascular aortic arch repair presents significant technical challenges, including maintaining cerebral perfusion and preventing embolization.
Purpose of the Study:
- To provide an overview of current endovascular techniques for aortic arch repair.
- To present and analyze the early outcomes of these innovative approaches.
Main Methods:
- Review of four primary endovascular aortic arch replacement techniques: hybrid repair, total endovascular approach, chimney grafts, and in-situ fenestration.
- Analysis of reported early clinical results for each technique.
Main Results:
- Early results for endovascular aortic arch repair techniques are encouraging.
- Custom-made fenestrated or branched stent-grafts show particularly promising early outcomes for total arch replacement.
Conclusions:
- Current endovascular techniques for aortic arch repair demonstrate potential.
- Long-term efficacy and safety require further investigation through larger studies and comparative trials.
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