Thoracic Branched Endografts in Acute Aortic Syndromes: Expanding Indications, but at What Cost?

Clinical ImpactOff-the-shelf thoracic branched endografts may facilitate urgent zone 2 TEVAR while preserving left subclavian artery perfusion and avoiding cervical debranching. However, acute aortic pathology increases the hazards of arch manipulation. Current evidence supports selective use in suitable anatomy and experienced centres, rather than routine adoption, until larger comparative studies better define safety and clinical benefit.