Challenge aortic arch：current evidence and future trend           GUO Wei，XU Yong-le. Department of Vascular Surgery, General Hospital of PLA, Beijing 100853, China
Corresponding author：GUO Wei，E-mail: pla301dml@vip.sina.com
Abstract    Conventional repair of aortic arch pathology is associated with significant mortality and stroke rates of 6%~20% and 3%~15%, respectively. So thoracic endovascular repair (TEVAR) in the management of aortic arch lesions is the trending topic. Until now, TEVAR involving aortic arch has been based on conventional or new devices. The former includes “hybrid/ de-branching” and “chimney” techniques, which were more often used clinically. There were some studies about the techniques, and the early and midterm outcomes were favorable. The latter includes “fenestrated stent graft” , “modular branched stent graft”, “multi-branched stent graft” , and so on. There were only a few case reports or other studies, and the experiences were limited. So the key solution about total TEVAR of aortic arch pathology is to design and develop new endovascular device. “branched stent graft” might match with aortic arch anatomy characteristics more.