Aortic arch repair: navigating the endovascular challenges

In this exclusive PVI 2026 interview, Dr Massara and Prof Ducasse discuss the evolving approaches to aortic arch repair, exploring the key considerations that guide treatment decisions in this complex anatomical territory.

They begin with the importance of a dedicated multidisciplinary aortic team and patient selection for endovascular repair, including the implications of small iliofemoral arteries and the management of urgent cases.

The discussion then turns to hybrid procedures versus total endovascular aortic arch repair, fenestrated endografts, in situ fenestration and the risk of endoleaks related to bridging stent disconnection.

They also examine the role of cardiac surgeons and pacing during the procedure, before reviewing clinical cases involving aortic arch and descending thoracic aortic aneurysms to illustrate the technical challenges and strategic considerations of these interventions.

Where anatomy, technology and procedural strategy meet, every decision can make a difference: discover how Dr Massara and Prof Ducasse approach the many challenges of aortic arch repair.