Hybrid Treatment for Thoracic and Thoracoabdominal Aortic Aneurysms in Patients Unfit for Open Conventional Repair

Abstract

Purpose : To describe a technique combining endovascular and conventional surgery for the treatment of distal aortic arch and thoracoabdominal aortic aneurysms.

Material and methods : In the last two years, we used hybrid approach to treat six patients with distal aortic arch or thoracoabdominal aortic aneurysms unfit for open conventional repair owing poor cardio-respiratory function. Results : The primary technical success rate was 100%. Intraoperative mortality rate was 0; conversion to open conventional repair was never required. Mean operation time and blood loss averaged 256 minutes and 1233 ml, respectively. Neurological complications were not observed. Overall, two patients died postoperatively. During a mean 17-month follow-up, two minor type II endoleak occurred and were successfully managed with coil embolization. All stent-grafts and conventional bypasses were patent, and no stent-graft-related complication was observed. Conclusion : Our initial experience attests the feasibility and potential attractive alternative of hybrid treatment for distal arch and thoracoabdominal aortic aneurysms.

Key Words:

• Hybrid treatment
• thoracic aneurysm
• thoracoabdominal aortic aneurysm
• carotid bypass
• visceral revas-cularization
• stent-graft

Additional information

Notes on contributors

G. Piffaretti

G. Piffaretti Department of surgery, Vascular surgery university of insubria viale Borri 57 I-21100 Varese, Italy Tel.: [phone] Fax: [phone] E-mail: [email protected]