Research progress on endovascular treatment of Stanford Type A aortic dissection

Thoracic endovascular aortic repair (TEVAR) has become the primary treatment for Stanford Type B aortic dissection. With the development of new endovascular grafts for the aortic arch, endovascular treatment for lesions involving all three branches of the aortic arch will gradually be applied in clinical practice. However, Stanford Type A aortic dissection (TAAD), owing to the anatomical characteristics of the aortic root and ascending aorta segment, as well as hemodynamic features, remains a formidable challenge in endovascular repair of aortic diseases. Endovascular repair of Type A aortic dissections presents several unresolved challenges, including significant anatomical variability (e.g., involvement of the coronary arteries, aortic valve, and diverse dissection morphologies), the ability of novel grafts to conform to complex anatomy, the integration of endovascular stents with valve interventions, and the maintenance of long-term coronary artery patency. Currently, there is no ideal endovascular solution or commercialized graft available. This article reviews the research progress in endovascular treatment for TAAD and outlines future technical development directions.