title: Current management of aortic arch lesions with hybrid procedures: a tailored approach to a progressive disease.
abstract: In the current era of cardiac and aortic surgery lines between open and endovascular approaches are becoming blurred. Hybrid techniques emerged with the availability of endovascular devices and the idea that combining open operations with a stent graft might provide a treatment option to those patients deemed too high-risk for conventional surgery. As these procedures evolved, it became clear that they still carried significant risk especially for the "inoperable" or "high-risk" patients, but they also offered new options for treating complex pathologies involving multiple segments of the aorta. Hybrid techniques not only provide the potential for less invasive aortic repair, but must be considered as an important complementary treatment option for patients with aortic disease, allowing for a potentially more effective and complete repair. The objective of this article is to review the current options for hybrid arch repair and the indications for choosing the various techniques based on pathologic presentation.
authors.affiliation: Aortic Center, Department of Thoracic and Cardiovascular Surgery, Heart and Vascular Institute, Cleveland Clinic, Cleveland, OH, USA - roselle@ccf.org.
authors.forename: Ryan P
authors.initials: RP
authors.lastname: Plichta
authors.forename: Muhammad
authors.initials: M
authors.lastname: Aftab
authors.forename: Eric E
authors.initials: EE
authors.lastname: Roselli
mesh_terms: D001013:Aorta, Thoracic / Q000473:pathology / Q000601:surgery*; D001018:Aortic Diseases / Q000473:pathology / Q000601:surgery*; D001807:Blood Vessel Prosthesis; D019917:Blood Vessel Prosthesis Implantation / Q000379:methods*; D018450:Disease Progression; D057510:Endovascular Procedures / Q000379:methods*; D006801:Humans; D018579:Patient Selection; D012307:Risk Factors; D015607:Stents