title: The hybrid stent-graft technique: a solution to complex aortic problems and lessons learned.
abstract: OBJECTIVE
  The frozen elephant trunk technique has been recently presented in the literature and has been considered as a novel surgical option for single-stage repair of complex aortic pathology such as combined arch and descending thoracic aortic aneurysms.
  
  
  METHODS
  The first patient, a 74-year-old male, was admitted severely symptomatic (interscapular pain), with aortic distal arch and proximal descending thoracic aortic aneurysm with a diameter of 6 cm. The second patient, a 72-year-old male, underwent descending aortic aneurysm stent grafting one year ago and was admitted gravely symptomatic (interscapular pain), with aortic arch aneurysm (diameter of 5.7 cm) and type I endoleak at the proximal end of the stent.
  
  
  RESULTS
  The first patient developed paraplegia after the operation and died three months after the operation due to pneumonia while he was on a rehabilitation program. The second patient's recovery was uneventful and was discharged on postoperative day nine.
  
  
  CONCLUSIONS
  This report summarizes our preliminary experience with this technique emphasizing two points: first, it offers the opportunity to manage efficiently complex aortic problems, and second, there is a potential risk of serious complications related to the limited stent sizes available of the device to match the patient's anatomical characteristics and pathology.
authors.affiliation: Second Cardiac Surgical Department, Evangelismos General Hospital, Athens, Greece.
authors.forename: John
authors.initials: J
authors.lastname: Kokotsakis
authors.forename: Panagiotis
authors.initials: P
authors.lastname: Misthos
authors.forename: Thanos
authors.initials: T
authors.lastname: Athanasiou
authors.forename: Timotheos
authors.initials: T
authors.lastname: Sakellaridis
authors.forename: Kostas
authors.initials: K
authors.lastname: Neofotistos
authors.forename: Elian
authors.initials: E
authors.lastname: Skouteli
authors.forename: Achilleas
authors.initials: A
authors.lastname: Lioulias
mesh_terms: D000368:Aged; D001011:Aorta / Q000473:pathology / Q000601:surgery*; D017545:Aortic Aneurysm, Thoracic / Q000473:pathology / Q000601:surgery*; D001018:Aortic Diseases / Q000473:pathology / Q000601:surgery*; D001807:Blood Vessel Prosthesis; D019917:Blood Vessel Prosthesis Implantation / Q000379:methods*; D013504:Cardiovascular Surgical Procedures / Q000379:methods*; D017809:Fatal Outcome; D006801:Humans; D008297:Male; D011446:Prospective Studies; D015607:Stents