• Recommendation 1: In patients who need elective TEVAR where achievement of a proximal seal necessitates coverage of the LSA, we suggest routine preoperative revascularization despite the very low-quality evidence (GRADE 2, level C).
• Recommendation 2: In selected patients who have an anatomy that compromises perfusion to critical organs, routine preoperative LSA revascularization is strongly recommended despite the very low-quality evidence (GRADE 1, level C).
• Recommendation 3: In patients who need very urgent TEVAR for lifethreatening acute aortic syndromes where achievement of a proximal seal necessitates coverage of the LSA, we suggest that revascularization should be individualized and addressed expectantly on the basis of anatomy, urgency, and availability of surgical expertise (GRADE 2, level C).