Background: Aortic dissection (AD) represents a clinically uncommon aortic pathology which predicts a dismal\nprognosis if not promptly treated. In acute Debakey type I AD (ADIAD), aortic lesion extends from aortic root to\neven distal abdominal aorta among which aortic arch and its three main branches still remain a great surgical\nchallenge for repair and reconstruction. Several decades have witnessed the painstaking efforts of cardiovascular\nsurgeons across the globe for optimizing the surgical procedures, from total or hemi-arch replacement, ââ?¬Å?elephant\ntrunkââ?¬Â technique to branched stent graft. However, operative mortality and morbidity still remain to be reduced\nand surgical strategy is to be advanced and simplified, particularly the repair and reconstruction of aortic arch and\nsupra-aortic vessels.\nMethods: In this paper, we reviewed the relevant literature concerning recent advances in surgical intervention of\naortic arch and summarized our opinions in the application of branched stent graft in ADIAD.\nResults: The operative strategy for acute Debakey type I aortic dissection still remain to be advanced and\nsimplified, especially the repair and reconstruction of aortic arch and supra-aortic vessels. For selection of branched\nstent grafts, the anatomic features and pathological changes of diseased arch are the crucial factors for clinical\ndecision making.\nConclusions: Branched stent graft is potentially an effective alternative for the treatment of type I AD with\ndiseased aortic arch and supra-aortic vessels. The selection of branched stent grafts still remains to be further\ndiscussed in large-scale studies in the future.
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