Various Endoluminal Approaches Available for Treating Pathologies of the Aortic Arch

Open surgical repair of the aortic arch for degenerative aortic disease in an unfit patient is associated with significant morbidity and mortality. Endoluminal techniques have advanced over the last decade. Contemporary endovascular options including a hybrid approach (supra-aortic debranching and a...

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Bibliographic Details
Published inCardiovascular and interventional radiology Vol. 43; no. 12; pp. 1756 - 1769
Main Authors Anwar, Muzaffar A., Hamady, Mohammad
Format Journal Article
LanguageEnglish
Published New York Springer US 01.12.2020
Springer Nature B.V
Subjects
Aorta
Aorta, Thoracic - diagnostic imaging
Aorta, Thoracic - surgery
Aortic Aneurysm, Thoracic - surgery
Aortic arch
Aortic Diseases - surgery
Blood Vessel Prosthesis - adverse effects
Blood Vessel Prosthesis Implantation - methods
Cardiology
Cardiovascular system
Complications
Durability
Endovascular Procedures - adverse effects
Endovascular Procedures - methods
Humans
Imaging
Implants
Medicine
Medicine & Public Health
Morbidity
Neurological complications
Nuclear Medicine
Prosthesis Design
Radiology
Review
Stents
Technology
Ultrasound
Endovascular aortic arch repair
Aortic arch aneurysm
Scallop
Branch stent graft
Total aortic arch replacement
Chimney
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Summary:Open surgical repair of the aortic arch for degenerative aortic disease in an unfit patient is associated with significant morbidity and mortality. Endoluminal techniques have advanced over the last decade. Contemporary endovascular options including a hybrid approach (supra-aortic debranching and aortic stent graft), inner branched endograft, chimney stents, and scallop or fenestrated endografts are being used frequently as an alternative to open surgical arch repair. Understanding of the available endoluminal technology along with careful planning and effective teamwork is required to minimise complications associated with the endoluminal techniques, particularly neurological ones. Custom made techniques are superior to chimney or parallel technology in terms of their complications and durability. Integration of the protective devices such as embolic protection filters into stent design may reduce the risk of poor neurological sequelae. Long-term data are needed to assess the durability of these devices.
Bibliography:ObjectType-Article-2
SourceType-Scholarly Journals-1
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ISSN:0174-1551
1432-086X
DOI:10.1007/s00270-020-02561-y