title: A staged replacement of the entire aorta from the ascending arch to the hypogastric arteries using a hybrid approach.
abstract: Combined open and endovascular hybrid procedures can be used to treat complex aortic pathology. This article reports a five-stage hybrid repair for a complex thoracoabdominal aneurysm with dissection in a 57-year-old man. To our knowledge, this is the first reported case of replacement and exclusion of the entire native human aorta from the root to the iliac bifurcations using a combined open and endovascular approach without neurologic complication. Bilateral hypogastric and femoral circulation was preserved. Aggressive spinal protective measures, including spinal drainage, motor-evoked potentials, and prevention of intraoperative and perioperative hypotension, were used during this staged approach.
authors.affiliation: Division of Vascular Surgery, University of California, Los Angeles, School of Medicine, Los Angeles, California, USA. jcjimene@gmail.com
authors.forename: Juan Carlos
authors.initials: JC
authors.lastname: Jimenez
authors.forename: Wesley S
authors.initials: WS
authors.lastname: Moore
mesh_terms: D000784:Aortic Dissection / Q000175:diagnosis / Q000601:surgery*; D017546:Angioscopy / Q000379:methods*; D017544:Aortic Aneurysm, Abdominal / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D017545:Aortic Aneurysm, Thoracic / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D001027:Aortography; D019917:Blood Vessel Prosthesis Implantation / Q000379:methods*; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D013908:Thoracotomy / Q000379:methods*; D014057:Tomography, X-Ray Computed