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ITALIAN JOURNAL OF VASCULAR AND ENDOVASCULAR SURGERY
Rivista di Chirurgia Vascolare ed Endovascolare
Italian Journal of Vascular and Endovascular Surgery 2015 March;22(1):5-14
Debranching TEVAR and total endovascular repair using branch devices for aortic arch pathologies
Kuratani T., Shirakawa Y., Shimamura K.
Department of Minimally Invasive Cardiovascular Medicine, Osaka University Graduate School of Medicine, Osaka, Japan
Debranching TEVAR has become a topic of interest for aortic arch pathologies, particularly in high-risk patients. Although satisfactory results have been obtained with this technique even for high-risk cases owing to its low invasiveness, the mid- and long-term results are still unclear. Here we describe the current status of this procedure for aortic arch pathologies (degenerative aneurysms and aortic dissections), and in particular debranching TEVAR (zone 2, 1, and 0 landing cases) for cases that need to extend to the aortic arch. We also discuss the prospects for this aortic arch field and devices for total endovascular arch repair. In the future, we will be able to perform TEVAR for ascending aorta using new devices including a chemical adhesive attachment system. In addition, if there will be an opportunity to use double side branch devices, the true total endovascular aortic arch repair will be completed on the horizon. This may seem a flight of fancy, although if we consider the progress achieved in the field over the last 20 years, we can definitely hold high hopes for the future.