Techniques for aortic arch endovascular repair.

Kiattisak Hongku, Nuno Dias, Björn Sonesson, Tim Resch

Research output: Contribution to journalReview articlepeer-review


This article reviews endovascular strategies for aortic arch repair. Open repair remains the gold standard particularly for good risk patients. Endovascular treatment potentially offers a less invasive repair. Principles, technical considerations, devices and outcomes of each technique are discussed and summarized. Hybrid repair combines less invasive revascularization options, instead of arch replacement while extending stent graft into the arch. Outcomes vary with regard to extent of repair and aortic arch pathologies treated. Results of arch chimney and other parallel graft techniques perhaps make it a less preferable choice for elective cases. However, they are very appealing options for urgent or bailout situations. Fenestrated stent grafting is subjected to many technical challenges in aortic arch due to difficulties in stent graft orientation and fenestration positioning. In situ fenestration techniques emerge to avoid these problems, but durability of stent grafts after fenestration and ischemic consequences of temporary carotid arteries coverage raises some concern total arch repair using this technique. Arch branched graft is a new technology. Early outcomes did not meet the expectation; however the results have been improving after its learning curve period. Refining stent graft technologies and implantation techniques positively impact outcomes of endovascular approaches.
Original languageEnglish
Pages (from-to)421-436
JournalJournal of Cardiovascular Surgery
Issue number3
Early online date2016 Mar 4
Publication statusPublished - 2016

Subject classification (UKÄ)

  • Cardiac and Cardiovascular Systems
  • Surgery


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