title: Hybrid procedures combining conventional and thoracic endovascular aortic repair for thoracic aortic aneurysms.
abstract: OBJECTIVE
  To minimize surgical invasiveness for extensive aortic aneurysms and expand the indications for thoracic endovascular aortic repair (TEVAR), we evaluated outcomes of hybrid procedures combining conventional surgical aortic repair and TEVAR for thoracic aortic aneurysms.
  
  
  METHODS
  The following hybrid procedures were performed: second-stage TEVAR after total aortic arch replacement using the elephant trunk as the landing zone in 17 patients; and for multiple aortic aneurysms, vascular graft replacement and TEVAR in 13 patients, vascular graft replacement and TEVAR with bypass in 2 patients, and TEVAR with bypass in 23 patients.
  
  
  RESULTS
  There were three (5.3%) hospital deaths, from serious complications including stroke, paraplegia, paraparesis, and aspiration pneumonia; and eight late deaths. There was only one aneurysm-related death, of a patient who underwent emergency surgery for an esophageal fistula resulting from enlargement of a residual false lumen of a thoracoabdominal aorta after second-stage TEVAR.
  
  
  CONCLUSIONS
  Hybrid procedures minimize surgical invasiveness in thoracic aortic aneurysm repair, but further evaluation of a larger number of patients is necessary.
authors: Department of Vascular Surgery, Tokyo Medical University, 6-7-1 Nishishinjuku, Shinjuku-ku, Tokyo, 160-0023, Japan.
authors: Yukio
authors: Y
authors: Obitsu
authors: Nobusato
authors: N
authors: Koizumi
authors: Satoshi
authors: S
authors: Takahashi
authors: Yasunori
authors: Y
authors: Iida
authors: Naozumi
authors: N
authors: Saiki
authors: Yoshiko
authors: Y
authors: Watanabe
authors: Satoshi
authors: S
authors: Kawaguchi
authors: Hiroshi
authors: H
authors: Shigematsu
mesh_terms: D000368:Aged; D000784:Aortic Dissection / Q000601:surgery*; D001013:Aorta, Thoracic / Q000601:surgery*; D017545:Aortic Aneurysm, Thoracic / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D016896:Treatment Outcome