Experiences with ascending aortic endografts using FDA IDE approved devices. What has been done, what lesions can be treated and what challenges remain.

Thoracic endovascular aortic repair (TEVAR) has become an attractive treatment option for thoracic aortic disease. New devices and advanced image-guided procedures are continuously expanding the indications. With improving device technology, diverse stent-graft availability, and imaging modalities, TEVAR has become safer and holds promising potential to expand treatment options, especially for ascending aorta and aortic arch pathology. This article focuses on current evolving endovascular solutions for thoracic ascending aortic diseases and starts with an overview of historical TEVAR landmarks, followed by indications for TEVAR, and concludes with present day challenges.