Abstract
Background: The management of aortic arch pathologies represents a great
challenge and is associated with high rates of mortality and morbidity.
A superior endovascular approach via thoracic endovascular aortic repair
(TEVAR) has been introduced to treat arch pathologies with specifically
designed endografts. This approach was shown to benefit patients who are
deemed ‘high risk’ for undergoing OSR as it is a greatly less
invasiveness option and thus, yields lower rates of morbidity and
mortality. Aims: This commentary aims to discuss the recent study by Tan
et al. which reports original data on the neurological outcomes after
endovascular repair of the aortic arch using the RELAY™ Branched device.
Methods: We carried out a literature search on multiple electronic
databases including PubMed, Ovid, Google Scholar, Scopus and EMBASE in
order to collate research evidence on the neurological outcomes of
endovascular aortic arch repair with TEVAR. Results: Tan and colleagues
showed through their original clinical data that the RELAY™ Branched
device has a high rate of technical success and favourable neurological
outcomes. There were no reported neurological deficits in patients who
received the triple-branched RELAY™ Branched device. Conclusion: The
RELAY™ Branched endograft is well-established for candidates for aortic
arch endovascular repair with favourable neurological outcomes. Multiple
considerations can help control the incidence of stroke following
endovascular repair. These include optimization of the supra-aortic
vessels’ revascularization, weighting the embolic risk in patients with
atheromatous disease, and careful preoperative assessment to select the
best candidates for arch endovascular repair