Endovascular stent graft repair (EVAR) has revolutionized the management of aneurysms and dissections of the thoracic and abdominal aorta and is considered the first-line treatment in such pathologies. Initially designed for patients unfit for open repair, EVAR and thoracic endovascular aortic stent graft repair are associated with improved morbidity and mortality and a faster recovery process. The endovascular revolution of the aorta continues moving proximally, with fenestrated and branch stent grafts currently in clinical trials for the management of thoracoabdominal aortic aneurysms, and several branched thoracic devices are either approved or in trial for management of aortic arch pathologies. The final frontier in the endovascular management of the aorta is the aortic root and ascending aorta. The first early feasibility trial for management of type A aortic dissection has recently concluded with a multicenter phase 2 study slated for the spring of 2023. The following article updates the reader on the unique challenges of endovascular management of the ascending aorta and a look at the future technologies that will define this space.

Original languageEnglish (US)
Pages (from-to)29-37
Number of pages9
JournalMethodist DeBakey cardiovascular journal
Issue number2
StatePublished - 2023


  • ascending aortic aneurysm
  • ascending aortic dissection
  • ascending aortic stent graft
  • endovascular ascending repair
  • Blood Vessel Prosthesis Implantation/adverse effects
  • Humans
  • Endovascular Procedures/adverse effects
  • Treatment Outcome
  • Blood Vessel Prosthesis
  • Prosthesis Design
  • Aortic Aneurysm, Thoracic/diagnostic imaging
  • Multicenter Studies as Topic
  • Aorta, Abdominal
  • Stents
  • Aorta, Thoracic/surgery

ASJC Scopus subject areas

  • Medicine(all)


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