title: Hybrid treatment of aortic arch disease.
abstract: BACKGROUND
  The management of thoracic aortic disease involving the ascending aorta, aortic arch and descending thoracic aorta are technically challenging and is an area in constant development and innovation.
  
  
  OBJECTIVE
  To analyze early and midterm results of hybrid treatment of arch aortic disease.
  
  
  METHODS
  Retrospective study of procedures performed from January 2010 to December 2012. The end points were the technical success, therapeutic success, morbidity and mortality, neurologic outcomes, the rate of endoleaks and reinterventions.
  
  
  RESULTS
  A total of 95 patients treated for thoracic aortic diseases in this period, 18 underwent hybrid treatment and entered in this study. The average ages were 62.3 years. The male was present in 66.7%. The technical and therapeutic success was 94.5% e 83.3%. The perioperative mortality rate of 11.1%. There is any death during one-year follow- up. The reoperation rates were 16.6% due 2 cases of endoleak Ia and one case of endoleak II. There is any occlusion of anatomic or extra anatomic bypass during follow up.
  
  
  CONCLUSIONS
  In our study, the hybrid treatment of aortic arch disease proved to be a feasible alternative of conventional surgery. The therapeutic success rates and re- interventions obtained demonstrate the necessity of thorough clinical follow-up of these patients in a long time.
authors.affiliation: Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brasil.
authors.forename: Patrick Bastos
authors.initials: PB
authors.lastname: Metzger
authors.affiliation: Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brasil.
authors.forename: Fabio Henrique
authors.initials: FH
authors.lastname: Rossi
authors.affiliation: Seção Médica de Radiologia, Centro de Intervenções Endovascular, Instituto Dante Pazzanese de Cardiologia, São Paulo, SP, Brasil.
authors.forename: Samuel Martins
authors.initials: SM
authors.lastname: Moreira
authors.affiliation: Secretaria da Saúde do Estado de São Paulo, São Paulo, SP, Brasil.
authors.forename: Mario
authors.initials: M
authors.lastname: Issa
authors.affiliation: Seção Médica de Cirurgia Vascular, Centro de Intervenções, Instituto Dante Pazzanese de Cardiologia, São Paulo, SP, Brasil.
authors.forename: Nilo Mitsuru
authors.initials: NM
authors.lastname: Izukawa
authors.affiliation: Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brasil.
authors.forename: Jarbas J
authors.initials: JJ
authors.lastname: Dinkhuysen
authors.affiliation: Hospital Salvalus, São Paulo, SP, Brasil.
authors.forename: Domingos
authors.initials: D
authors.lastname: Spina Neto
authors.affiliation: Universidade Federal de São Paulo, São Paulo, SP, Brasil.
authors.forename: Antônio Massamitsu
authors.initials: AM
authors.lastname: Kambara
mesh_terms: D000368:Aged; D000792:Angiography / Q000379:methods; D001013:Aorta, Thoracic / Q000000981:diagnostic imaging / Q000601:surgery*; D001018:Aortic Diseases / Q000000981:diagnostic imaging / Q000401:mortality / Q000601:surgery*; D017536:Carotid Artery, Common / Q000000981:diagnostic imaging / Q000601:surgery; D057867:Endoleak / Q000209:etiology; D057510:Endovascular Procedures / Q000379:methods* / Q000401:mortality; D005260:Female; D006801:Humans; D007431:Intraoperative Complications; D008297:Male; D008488:Medical Illustration; D008875:Middle Aged; D011183:Postoperative Complications; D012189:Retrospective Studies; D012307:Risk Factors; D015607:Stents; D013997:Time Factors; D014057:Tomography, X-Ray Computed / Q000379:methods; D016896:Treatment Outcome