title: Midterm outcomes of carotid-to-carotid bypass for hybrid treatment of aortic arch disease.
abstract: BACKGROUND
  The purpose of this study was to compare midterm results of carotid-to-carotid bypass (CCB) after hybrid repair of aortic arch disease.
  
  
  METHODS
  Between October 2001 and April 2012, all patients undergoing hybrid aortic arch repair with CCB were enrolled. CCBs were positioned in the subcutaneous or in the retropharyngeal position. Hybrid aortic arch repair was performed in a single-stage intervention.
  
  
  RESULTS
  We treated 19 (82.6%) men and 4 women; mean age was 74 ± 6 years (range, 58-83 years). Subcutaneous tunnelization was performed in 15 (65.5%) cases and the retropharyngeal route in 8 (34.5%). In-hospital mortality was 8.7% (n = 2); causes of death were major stroke (n = 1) and respiratory failure (n = 1). Cranial nerve injuries (transient or permanent), dysphagia, or local problems were not observed. Tracheostomy was never required. Early outcomes did not differ between the 2 types of bypass. Mean follow-up was 44 months (range, 1-118; median 24). Survival rate at 1, 3, and 5 years was 70% ± 9.6%, 55% ± 10.7%, and 50% ± 11.1%, respectively. At the time of the last follow-up control, all bypasses were patent: stenosis and thrombosis were not recorded. Bypass graft or endograft infection were not registered. Shrinkage of the aortic lesion was observed in 15 (71.4%) cases.
  
  
  CONCLUSIONS
  CCBs are durable at midterm follow-up. No relevant superiority was identified between the 2 types of CCB; subcutaneous and retropharyngeal routes proved to be equally safe.
authors.affiliation: Vascular Surgery, Department of Cardiovascular and Thoracic Sciences, G. Martino University Teaching Hospital, University of Messina School of Medicine, Messina, Italy.
authors.forename: Filippo
authors.initials: F
authors.lastname: Benedetto
authors.affiliation: Vascular Surgery, Department of Surgery and Morphological Sciences, Circolo University Teaching Hospital, University of Insubria School of Medicine, Varese, Italy. Electronic address: gabriele.piffaretti@uninsubria.it.
authors.forename: Gabriele
authors.initials: G
authors.lastname: Piffaretti
authors.affiliation: Vascular Surgery, Department of Surgery and Morphological Sciences, Circolo University Teaching Hospital, University of Insubria School of Medicine, Varese, Italy.
authors.forename: Matteo
authors.initials: M
authors.lastname: Tozzi
authors.affiliation: Vascular Surgery, Department of Cardiovascular and Thoracic Sciences, G. Martino University Teaching Hospital, University of Messina School of Medicine, Messina, Italy.
authors.forename: Narayana
authors.initials: N
authors.lastname: Pipito'
authors.affiliation: Vascular Surgery, Department of Cardiovascular and Thoracic Sciences, G. Martino University Teaching Hospital, University of Messina School of Medicine, Messina, Italy.
authors.forename: Domenico
authors.initials: D
authors.lastname: Spinelli
authors.affiliation: Vascular Surgery, Department of Surgery and Morphological Sciences, Circolo University Teaching Hospital, University of Insubria School of Medicine, Varese, Italy; Cardiac Surgery, Department of Surgery and Morphological Sciences, Circolo University Teaching Hospital, University of Insubria School of Medicine, Varese, Italy.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Mariscalco
authors.affiliation: Vascular Surgery, Department of Cardiovascular and Thoracic Sciences, G. Martino University Teaching Hospital, University of Messina School of Medicine, Messina, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Spinelli
authors.affiliation: Vascular Surgery, Department of Cardiovascular and Thoracic Sciences, G. Martino University Teaching Hospital, University of Messina School of Medicine, Messina, Italy.
authors.forename: Patrizio
authors.initials: P
authors.lastname: Castelli
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001013:Aorta, Thoracic / Q000000981:diagnostic imaging / Q000601:surgery*; D001018:Aortic Diseases / Q000000981:diagnostic imaging / Q000401:mortality / Q000601:surgery*; D001027:Aortography / Q000379:methods; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects / Q000401:mortality; D002339:Carotid Arteries / Q000000981:diagnostic imaging / Q000601:surgery*; D057510:Endovascular Procedures / Q000009:adverse effects / Q000401:mortality; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D056888:Patient Positioning; D012189:Retrospective Studies; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome