title: Hybrid operation for a thoracoabdominal aortic aneurysm.
abstract: OBJECTIVE
  The treatment of thoracoabdominal aortic aneurysms remains an ongoing challenge in vascular surgery and has been associated with high periprocedural mortality. Since the introduction of endovascular procedures in the treatment of aortic pathologies during the last decade, new therapeutic options have arisen. We report here some technical aspects of a 2-step hybrid-procedure that consists of an initial debranching of all visceral arteries by perfusing them through a special vascular prosthesis, which is anastomosed to the healthy common iliac artery. The second step is performed after recovery of the patient from the debranching procedure and stentgraft prostheses are implanted to fully exclude the aneurysm.
  
  
  METHODS
  Thoracoabdominal aortic aneurysm.
  
  
  METHODS
  Two-step hybrid-procedure for treatment of thoracoabdominal aneurysms.
  
  
  CONCLUSIONS
  In our opinion, this procedure is, although technically demanding, safely performable with a tolerable periprocedural morbidity and mortality. Major advantages are the restriction to one visceral cavity and a sequential debranching that allows us to avoid use of a temporary bypass. This procedure appears to be a promising alternative to conventional thoracoabdominal aortic repair in centres with expertise in visceral artery revascularisation.
authors.affiliation: Klinik und Poliklinik für Viszeral-, Thorax- und Gefäßchirurgie, UniversitätsGefäßCentrum, Universitätsklinikum Dresden.
authors.forename: S
authors.initials: S
authors.lastname: Ludwig
authors.forename: R
authors.initials: R
authors.lastname: Hoffmann
authors.forename: R
authors.initials: R
authors.lastname: Grützmann
mesh_terms: D000714:Anastomosis, Surgical / Q000379:methods; D017545:Aortic Aneurysm, Thoracic / Q000175:diagnosis / Q000601:surgery*; D001807:Blood Vessel Prosthesis; D002445:Celiac Artery / Q000601:surgery; D003299:Cooperative Behavior; D006801:Humans; D007083:Iliac Artery / Q000601:surgery; D033183:Interdisciplinary Communication; D008297:Male; D017538:Mesenteric Artery, Superior / Q000601:surgery; D011474:Prosthesis Design; D012077:Renal Artery / Q000601:surgery; D012086:Reoperation; D015607:Stents; D013536:Suture Techniques; D014781:Viscera / Q000098:blood supply