title: Editor's choice--hybrid treatment of thoracic, thoracoabdominal, and abdominal aortic aneurysms: a multicenter retrospective study.
abstract: OBJECTIVE
  The aim of this study was to assess the results of hybrid techniques for the treatment of thoracic, thoracoabdominal, and abdominal aortic aneurysms based on multicenter results and the various series regarding hybrid procedures reported in the literature.
  
  
  METHODS
  The results of 76 hybrid procedures performed in 19 French university hospital centers between November 2001 and October 2011 were collected. There were 50 men and 26 women, mean age 68.2 (35-86) years. All patients were considered at high risk (ASA≥3) for conventional surgery. Aneurysms involved the thoracic, abdominal, and thoracoabdominal aorta in five, 14, and 57 cases respectively. There were 11 emergent repairs. The revascularization of four visceral arteries was performed in 38 cases. Between one and three visceral arteries were revascularized in the other cases. Visceral artery debranching and stent graft deployment were performed in a one-stage procedure in 53 cases and in a two-stage procedure in 23 cases.
  
  
  RESULTS
  There were 26 (34.2%) postoperative deaths. Nine of the survivors developed paraplegia, of which one resolved completely. Bowel ischemia occurred in 13 cases (17.1%), and one patient was treated by a superior mesenteric artery bypass. Four patients required long-term hemodialysis. Postoperative computed tomography scan showed a type II endoleak in two patients.
  
  
  CONCLUSIONS
  Morbidity and mortality in this study were greater than previously reported. Candidates for hybrid aortic repair should be carefully selected.
authors.affiliation: CHU Clermont-Ferrand, France. Electronic address: erosset@chu-clermontferrand.fr.
authors.forename: E
authors.initials: E
authors.lastname: Rosset
authors.affiliation: CHU Clermont-Ferrand, France.
authors.forename: S
authors.initials: S
authors.lastname: Ben Ahmed
authors.affiliation: CHU Clermont-Ferrand, France.
authors.forename: G
authors.initials: G
authors.lastname: Galvaing
authors.affiliation: CHU Saint-Etienne, France.
authors.forename: J P
authors.initials: JP
authors.lastname: Favre
authors.affiliation: CHU Grenoble, France.
authors.forename: C
authors.initials: C
authors.lastname: Sessa
authors.affiliation: CHU Lyon, France.
authors.forename: P
authors.initials: P
authors.lastname: Lermusiaux
authors.affiliation: CHU Nice, France.
authors.forename: R
authors.initials: R
authors.lastname: Hassen-Khodja
authors.affiliation: Ambroise Paré Hospital, France.
authors.forename: M
authors.initials: M
authors.lastname: Coggia
authors.affiliation: CHU Lille, France.
authors.forename: S
authors.initials: S
authors.lastname: Haulon
authors.affiliation: CHU Besançon, France.
authors.forename: S
authors.initials: S
authors.lastname: Rinckenbach
authors.affiliation: CHU Angers, France.
authors.forename: B
authors.initials: B
authors.lastname: Enon
authors.affiliation: CHU Grenoble, France.
authors.forename: P
authors.initials: P
authors.lastname: Feugier
authors.affiliation: CHU Dijon, France.
authors.forename: E
authors.initials: E
authors.lastname: Steinmetz
authors.affiliation: CHU Henri Mondor, Creteil, France.
authors.forename: J P
authors.initials: JP
authors.lastname: Becquemin
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000792:Angiography; D017544:Aortic Aneurysm, Abdominal / Q000175:diagnosis / Q000453:epidemiology / Q000601:surgery*; D017545:Aortic Aneurysm, Thoracic / Q000175:diagnosis / Q000453:epidemiology / Q000601:surgery*; D001807:Blood Vessel Prosthesis; D005260:Female; D005602:France / Q000453:epidemiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009017:Morbidity / Q000639:trends; D012189:Retrospective Studies; D015996:Survival Rate / Q000639:trends; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014656:Vascular Surgical Procedures / Q000379:methods*
keywords: Endovascular aortic repair; Hybrid procedures; Thoracoabdominal aortic aneurysms