Through the endovascular looking glass: Total endovascular repair for combined congenital and acute aortic arch disease

Abstract

Perfusion to both arms and vertebral arteries can be well preserved. These endovascular devices are usually available in an endovascular suite and do not need a custom-made process. DISCUSSIONA Kommerell diverticulum that accompanies the aberrant left subclavian artery origin from right aortic arch usually expands with time. The risk of rupture and dissection increases with size expansion. In the endovascular era, arch debranching with aortic endografting is the mainstay of elective treatment for Kommerell diverticulum. 1 When an acute type B dissection complicates this picture, however, especially in the presence of malperfusion, surgical risk rises. If we can make the operation completely endovascular, it might be better tolerated. Our method, which uses bilateral subclavian artery snorkels and aortic endografting, is less invasive, although it requires expert endovascular and open skills to perform. It does not need custom-made devices and is suitable for emergency settings.Through the lens of endovascular aortic techniques, new treatment horizons for a broad spectrum of aortic diseases are coming into better focus. Although endovascular therapies for zone 0 appear off in the distance and are still a bit hazy, total endovascular arch repair is becoming a more focused reality. 1 As our understanding improves FIGURE 3. Three-dimensional reconstructed computed tomography in anteroposterior (left), lateral (center), and left posterior oblique (right) projections gives a clear overview of how the total endovascular repair was achieved.