Hybrid treatment for thoracic and thoracoabdominal aortic aneurysms in patients unfit for open conventional repair.
OBJECTIVE
To describe a technique combining endovascular and conventional surgery for the treatment of distal aortic arch and thoracoabdominal aortic aneurysms.


METHODS
In the last two years, we used hybrid approach to treat six patients with distal aortic arch or thoracoabdominal aortic aneurysms unfit for open conventional repair owing poor cardio-respiratory function.


RESULTS
The primary technical success rate was 100%. Intraoperative mortality rate was 0; conversion to open conventional repair was never required. Mean operation time and blood loss averaged 256 minutes and 1233 ml, respectively. Neurological complications were not observed. Overall, two patients died postoperatively. During a mean 17-month follow-up, two minor type II endoleak occurred and were successfully managed with coil embolization. All stent-grafts and conventional bypasses were patent, and no stent-graft-related complication was observed.


CONCLUSIONS
Our initial experience attests the feasibility and potential attractive alternative of hybrid treatment for distal arch and thoracoabdominal aortic aneurysms.
Castelli
P
P
Department of Surgery, University of Insubria, Varese-Italy.
Caronno
R
R
Piffaretti
G
G
Tozzi
M
M
Lomazzi
C
C
Laganà
D
D
Carrafiello
G
G
Cuffari
S
S
D000368:Aged; D000369:Aged, 80 and over; D000714:Anastomosis, Surgical; D001014:Aortic Aneurysm / Q000601:surgery*; D016063:Blood Loss, Surgical; D001807:Blood Vessel Prosthesis; D019917:Blood Vessel Prosthesis Implantation / Q000379:methods*; D005260:Female; D006304:Health Status; D006801:Humans; D008297:Male; D011138:Polytetrafluoroethylene; D015607:Stents; D013997:Time Factors
D011138:Polytetrafluoroethylene