Key result
Early stroke after endovascular aortic arch repair reaches up to ~43%, driven by embolization and perfusion.
Early postoperative stroke remains a critical complication of endovascular aortic arch repair, highlighting an unmet clinical need for detailed preoperative risk stratification and specific intraoperative prevention methods.
As the bottleneck of endovascular aortic arch repair, early postoperative stroke remains a devastating complication in high-risk patients and a critical concern for the development of optimal endovascular techniques and devices. The incidence of early postoperative stroke varies widely among currently available endovascular techniques and devices, with reported rates ranging from 0.0% to 42.9%, and is significantly influenced by the severity of the patient's preexisting aortic atherosclerotic burden, air released from the endovascular device, and a variety of factors leading to cerebral perfusion insufficiency. Currently, preidentification of high-risk patients and careful perioperative management appear to play a critical role in reducing stroke incidence. Specific intraoperative prevention methods are still lacking, but embolic protection devices and carbon dioxide or high-volume saline flushing of endovascular devices appear promising. Detailed preoperative stroke risk stratification and screening for optimal endovascular techniques and devices for aortic arch treatment are unmet clinical needs.
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Cao et al. (2023) conducted a review in Endovascular aortic arch repair. Endovascular aortic arch repair was evaluated on Early postoperative stroke. The incidence of early postoperative stroke following endovascular aortic arch repair varies widely from 0.0% to 42.9%, driven by atherosclerotic burden, device air release, and perfusion issues.
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