Hybrid repair of aortic arch pathology.
The objective was to evaluate a 13-year single-centre experience of arch endovascular aortic repair using the hybrid approach. Between 1999 and 2013, 491 patients were treated with endografts for thoracic aortic pathologies. The aortic arch was involved in 179 (36.5%) patients (128 men; mean age 70.2 ± 10.8 years, range 27-84). A hybrid approach was performed for all Zone 0 and 1 procedures and in nearly half of Zone 2 procedures. Early and mid-term outcomes were reviewed retrospectively. Overall primary technical success (24 h) was achieved in 162 (90.5%) of the 179 cases; 2 deaths and 15 Type 1 endoleaks were observed. Clinical success at 30 days was achieved in 161 (89.9%) of the 179 patients, with a mortality rate of 4.5% (8/179). Short-term clinical success at 6 months was achieved in 169 (94.4%) of the 179 patients; the rates for the different landing zones did not differ significantly. At a mean follow-up of 27.3 ± 15.7 months (range 1-94), the mid-term clinical success was 165 (92.2%) of the 179 patients; the rates among the different proximal zones did not differ significantly. In selected patients, early and mid-term outcomes of arch endovascular aortic repair using the hybrid approach are promising; however, mortality and morbidity are not negligible. Our results may have practical implications for the ongoing evaluation of the hybrid procedure in the aortic arch, as well as for patients fit for traditional surgery.
['Chiesa|Roberto|R|', 'Bertoglio|Luca|L|', 'Rinaldi|Enrico|E|', 'Tshomba|Yamume|Y|']
D000368:Aged D000369:Aged, 80 and over D001013:Aorta, Thoracic D001018:Aortic Diseases D001807:Blood Vessel Prosthesis D019917:Blood Vessel Prosthesis Implantation D057867:Endoleak D057510:Endovascular Procedures D005260:Female D006801:Humans D053208:Kaplan-Meier Estimate D008297:Male D008875:Middle Aged D016343:Monitoring, Intraoperative D019990:Perioperative Care D012189:Retrospective Studies D012307:Risk Factors D015607:Stents D020521:Stroke D014057:Tomography, X-Ray Computed D016896:Treatment Outcome
Hybrid Arch Endovascular Aneurysm Debranching Stent-graft