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Endovascular Treatment Options for the Aortic Arch
Akiko Tanaka1, Anthony Estrera1
1Department of Cardiothoracic and Vascular Surgery, McGovern Medical School at The University of Texas Health Science Center at Houston (UTHealth) and Memorial Hermann Hospital, 6400 Fannin Street, Suite #2850, Houston, TX 77030, USA.
Interventional Cardiology Clinics
|October 3, 2018
Summary
Endovascular aortic repair offers new options for aortic arch abnormalities, especially for high-risk patients. Custom branched endografts show promise, but preparation time limits urgent use, with commercial devices expected soon.
Area of Science:
- Vascular Surgery
- Interventional Cardiology
- Medical Device Technology
Background:
- Endovascular aortic repair (EVAR) has significantly advanced aortic arch abnormality treatment over 20 years.
- EVAR provides alternatives for patients unsuitable for traditional open surgical repair.
- Tailoring devices and techniques to individual anatomy and abnormality extent is crucial.
Purpose of the Study:
- To review the current state and future directions of endovascular aortic repair for aortic arch abnormalities.
- To highlight the advantages and limitations of branched endografts in this context.
Main Methods:
- Review of recent studies and clinical outcomes related to endovascular aortic repair for aortic arch pathologies.
- Analysis of device-specific challenges, particularly custom graft preparation times.
Main Results:
- Branched endografts demonstrate promising results for complex aortic arch lesions.
- A significant drawback is the extended preparation time for custom-made grafts, impacting emergent/urgent case suitability.
Conclusions:
- Endovascular techniques are expanding treatment options for aortic arch abnormalities.
- Availability of commercially produced devices is anticipated to improve accessibility for urgent cases.
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