Stroke and total endovascular arch repair

Total endovascular aortic arch repair (EAAR) has become a viable option for repair of aortic arch pathology. Stroke risk, largely embolic, remains the most devastating complication. This review discusses the mechanism of stroke, stroke definitions, and published stroke risk in currently available EAAR devices and off-label EAAR solutions. Defining stroke standards in this patient cohort remains imperative with evolving technology and is closely linked to stroke standards in open aortic arch repair. With expanding indications, stroke risk must be at least equivalent to that of open arch repair.