Current status of total endovascular arch replacement-What are the outcomes and who should get them: A comprehensive...

Several different forms of endovascular arch repair are available in practice today. Custom-made devices, represented by fenestrated and branched endografts, have emerged as the first line in endovascular repair and offer broad applicability. Off-the-shelf devices are becoming more common, but emergent repair is still most likely to use in situ fenestration or physician-modified endograft techniques. The current outcomes of these devices are encouraging, even if total endovascular arch repair presents limitations. Careful patient selection, based on anatomical features and previous medical history, and the presence of a well-developed aortic team are the 2 key factors that ensure good outcomes after endovascular repair.