title: [Hybrid treatment of aortic arch disease with ascending aorta to carotid artery revascularization and subsequent endovascular repair].
abstract: OBJECTIVE
  To summarize the experience of treating aortic arch disease with ascending aorta to carotid artery revascularization and subsequent endovascular repair.
  
  
  METHODS
  From January 2002 to June 2013, 10 high risk patients with aortic arch disease were treated with ascending aorta to carotid artery revascularization with subsequent endovascular repair in the First Affiliated Hospital, Sun Yat-sen University. There were 9 male and 1 female patients with a mean age of (54 ± 14) years (ranging from 34 to 71 years). Of the 10 patients, 8 were aortic dissection and 2 were thoracic aortic aneurysm. All aortic arch debranching was performed with mid-sternotomy, including 7 ascending aorta to innominate artery and left common carotid artery bypass, and 3 ascending aorta to left common carotid artery and left subclavian artery bypass.Subsequently, simultaneous (n = 5) and staged (n = 5, mean interval (7 ± 4) days) endovascular repair were performed via femoral artery.
  
  
  RESULTS
  Technical success rate was 10/10. The 30 day-mortality was 3/10, including 1 brain stem infarction, 1 circulatory failure and 1 aorto-tracheal fistula. Complication included 1 type II endoleak. The median time of follow-up was 24 (14) months. CT scanning was performed at 1, 3 months and annually thereafter. There was no death and no occlusion of bypass during follow-up.No complication occurred except 1 existing type II endoleak.
  
  
  CONCLUSIONS
  Ascending aorta to carotid artery revascularization with subsequent endovascular repair is suitable for high risk aortic arch pathology patients in poor general condition with little tolerance to aortic arch replacement.
authors.affiliation: Department of Vascular Surgery, the First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510080, China.
authors.forename: Mian
authors.initials: M
authors.lastname: Wang
authors.affiliation: Department of Vascular Surgery, the First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510080, China. Email: 13922231628@163.com.
authors.forename: Guangqi
authors.initials: G
authors.lastname: Chang
authors.affiliation: Department of Vascular Surgery, the First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510080, China.
authors.forename: Shenming
authors.initials: S
authors.lastname: Wang
authors.affiliation: Department of Vascular Surgery, the First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510080, China.
authors.forename: Henghui
authors.initials: H
authors.lastname: Yin
authors.affiliation: Department of Vascular Surgery, the First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510080, China.
authors.forename: Chen
authors.initials: C
authors.lastname: Yao
authors.affiliation: Department of Vascular Surgery, the First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510080, China.
authors.forename: Jinsong
authors.initials: J
authors.lastname: Wang
authors.affiliation: Department of Vascular Surgery, the First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510080, China.
authors.forename: Songqi
authors.initials: S
authors.lastname: Li
mesh_terms: D000328:Adult; D000368:Aged; D000784:Aortic Dissection; D001011:Aorta; D001014:Aortic Aneurysm; D017545:Aortic Aneurysm, Thoracic; D001018:Aortic Diseases / Q000601:surgery*; D019917:Blood Vessel Prosthesis Implantation; D016122:Brachiocephalic Trunk; D017536:Carotid Artery, Common; D057867:Endoleak; D057510:Endovascular Procedures; D005260:Female; D005263:Femoral Artery; D006801:Humans; D008297:Male; D008875:Middle Aged; D056346:Sternotomy; D013348:Subclavian Artery; D014057:Tomography, X-Ray Computed; D014656:Vascular Surgical Procedures; D014945:Wound Healing