The current status of endovascular aortic arch repair

Endovascular aortic arch repair provides treatment opportunity for patients with aortic arch dissection and aneurysm who are intolerant to open surgery. The aortic arch branches provide the blood flow for brain, the revascularization of these branches is part and parcel of the endovascular aortic arch repair. The anatomical configuration, high-speed blood flow and long access from femoral artery increase the difficulty of endovascular aortic arch repair. Debranch technique, combined with chimney, scallop, and fenestration, have partially simplified the endovascular aortic arch repair. The dedicated endografts for aortic arch is becoming a research focus. In the design of aortic arch endografts, fenestrated and branched stent-grafts are the two main strategies. A variety of innovative concepts have been applied in the design of aortic arch endografts, including modular and integrated design, inner branch and outer branch design, single branch and multi-branch design, etc. Today, these procedures of complex endovascular aortic arch repair still need to be limited to experienced centers. Endovascular aortic arch repair showed favorable short-term outcomes through the development of strict surgical plans, as well as effective teamwork. Long-term efficacy and safety in larger participants need further investigation.