Total arch replacement with TBE-double TBE or zone 0 TBE with debranching, other methods-What is the safest approach: Data and techniques.

Open arch repair remains the gold standard for the treatment of aortic arch pathology. However, complete endovascular aortic arch repair has been performed with excellent outcomes in Europe and in the context of a physician-sponsored investigational device exemption trial within the United States. Because these customized grafts are not readily available, hybrid techniques have evolved to treat aortic arch pathology. Hybrid techniques that combine cervical debranching and the use of the GORE thoracic branched endograft (TBE) have enabled the ability to repair aortic arch pathology with less invasive means using commercially available endografts, with reduced morbidity and mortality. Hybrid approaches using the GORE TBE platform are described herein.