Hybrid procedures in abdominal and thoracic aorta aneurysms

Objective: This study aims to show hybrid treatment techniques used in complex thoracic and abdominal aortic aneurysms and to show the results, complications and alternatives of these treatment methods. Material and methods: The study consisted of 15 patients who were treated hybridly with the collaboration of Cardiovascular Surgery Department who underwent stent graft implanation due to thoracic and abdominal aortic aneurysm in Department of Radiology-Interventional Radiology Section between 2013-2018. Debranching operation was performed to all patients by Cardiovascular Surgery and after debranching , stent-graft placement was performed in the Interventional Radiology Section-Angiography Unit. Patient's medical records kept in the cardiovascular surgery and Istanbul Medical Faculty PACS archive system has been used to evaluate the details of hybrid procedures. Results: 86.6% of the patients are male. Their average age is 71.6 ± 13.3. There is no medical disease in 6.6% of the patients. Indications were found in 40% of patients as thoracoabdominal aorta aneurysm and in 13.3% of patients as developing type 1b endoleak after endovascularly treated thoracoabdominal aneurysm. TEVAR was applied to 86.6% of the patients. TEVAR-EVAR endovascular techniques were applied to 13.3% of the patients. When the intervention outcome states of the patients were evaluated, only in 20% of patients type 1a endoleak was found. 30-day and 1-year mortalities of the patients were evaluated, the presence of 13.3% and 33.3% mortality was determined, respectively. No complication was detected in 66.6% of the patients. Conclusions: Hybrid methods minimize the disadvantages of the other methods in the treatment of aneurysm. Avoidance to perform aortic clamping procedures with large incisions, eliminating the thoracotomy necessity reduces morbidity and mortality. Providing perfusion of critical visceral or cerebral vessels with debranching surgeries has expanded the aortic landing zones that are suitable for graft implantation. For these reasons, hybrid treatment methods are seen as a good alternative in complex aortic aneurysms.