As we approach one full year since the novel coronavirus first became known to us, we reflect on the seemingly innumerable losses in its wake but also on the resolve of the global population and its health care workers striving to stem this tide. In our field, we especially focus on those efforts to minimize the effects of COVID-19 on the vital work done every day for patients with vascular diseases and injuries—many whose care cannot wait, no matter what the extenuating circumstance. We reflect with humility on all we did not know at the close of 2019, about epidemiology, preparedness, quarantine, virtual extensions, and especially about ourselves and our ability to adapt and respond. On all we still do not know.

Aortic specialists and teams around the world have faced the challenging reality that the thresholds for treating many aortic pathologies cannot change due to external circumstances. Even in nonemergent presentations, time is of the essence for these patients, and our work remains essential despite the ongoing presence of COVID-19.

Against this backdrop, we are proud to introduce this month’s edition of Endovascular Today focusing on thoracic aortic disease and repair. The global aortic community is one of great camaraderie and collegiality, eager to share in each other’s hardships as well as achievements.

To open our feature, Mohamed A. Abdelhalim, MRCS, and Bijan Modarai, PhD, share insights on the technology and strategies needed to minimize radiation exposure and improve efficiency during complex endovascular aortic cases.

Next, Joseph V. Lombardi, MD, and G. Chad Hughes, MD, summarize the updated language from the recently published Society for Vascular Surgery and Society of Thoracic Surgeons reporting standards for type B aortic dissection.

Turning to our first of two panel discussions, Linda M. Harris, MD; Matthew P. Sweet, MD; Marcelo Ferreira, MD; Matheus Mannarino, MD; and Gabriela Velazquez-Ramirez, MD, ponder whether patients with impaired renal function and thoracoabdominal aortic aneurysm can be treated with an endovascular approach.

Kyle Reynolds, MD, and Javairiah Fatima, MD, then debate the optimal landing zone for thoracic endovascular aortic repair. This is followed by a primer on thoracic aortic trauma from Matthew Blecha, MD; Corinne Bunn, MD; Michael Soult, MD; and Vivian Gahtan, MD, where they cover everything from mechanism of injury and history of repair to indications for endovascular intervention, TEVAR techniques, and potential complications.

In our second panel discussion, Konstantinos P. Donas, MD; Drosos Kotelis, MD; Audra A. Duncan, MD; Gregory A. Magee, MD; and Vincent L. Rowe, MD, are asked if they think endovascular therapy is definitive for mycotic thoracic aortic aneurysms or simply a bridge therapy.

Rounding out our thoracic feature, Alexander S. Fairman, MD, and Grace J. Wang, MD, review the current status of spinal cord ischemia management, while Lindsey M. Korepta, MD, and Bernadette Aulivola, MD, take a look at the available literature on categorizing intramural hematomas and penetrating aortic ulcerations and when to treat them.

Elsewhere in this issue, the Endovascular Today editors have assembled a special focus on radial access applications, exploring learning curves, patient candidacy, room setup, and tips and tricks for various applications: neurointervention with Pascal M. Jabbour, MD; embolization with Tiago Bilhim, MD; Roberto Iezzi, MD; and Marcelo Guimaraes, MD; and lower extremity disease with Ricki Korff, MD; Alex Sher, MD; Raghuram Posham, MD; Rahul S. Patel, MD; and Aaron Fischman, MD.

This edition concludes with an interview with Sarah Onida, MBBS, on data-driven decision-making in the superficial venous field, metabolic phenotyping for venous disease, the COVER study on vascular practice during the pandemic, and much more.

Regardless of the focus of your vascular practice, we are proud to join you in unwavering commitment to patient care, throughout the pandemic, and hopefully soon, its aftermath.

Javairiah Fatima, MD, FACS, RPVI, DFSVS
Ian M. Loftus, MD, FRCS
Edward Y. Woo, MD
Guest Chief Medical Editors