Arch Branch Devices and Clinical Trials in Treatment of Aortic Arch Pathology

Abstract

Aortic arch endografting will undoubtedly expand in the population suitable for aortic arch repair. Currently, there are four endografts under investigation to treat aortic arch pathology including Gore's Thoracic Branch Endoprosthesis, Endospan's NEXUS Aortic Arch Stent Graft System, Terumo's RelayBranch Thoracic Stent-Graft System, and Cook's Zenith Arch Branched Graft. Despite advances in deployment technique, self-aligning features to mitigate aortic arch manipulation, and distal embolic protection, perioperative stroke continues to be high, limiting the devices from commercial availability. Here we discuss current devices under trial in the United States, limitations of aortic arch endografting, and future directions.