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Novel and Innovative Hybrid Technique for Type A Aortic Dissection
Published on: March 28, 2025
[Thoracoabdominal aortic aneurysm hybrid repair]
Csaba Dzsinich1, Kálmán Hüttl, Gaetano Cavarra
1Allami Egészségügyi Központ Szív-, Er- és Mellkassebészeti Osztály, Budapest, Hungary. escvs@medical.hu
Magyar Sebeszet
|April 23, 2008
Summary
Hybrid endovascular repair offers a less invasive option for complex thoracoabdominal aortic aneurysms. This case demonstrates a successful debranching procedure combined with endografting for a Crawford Type IV aneurysm.
Area of Science:
- Vascular Surgery
- Endovascular Interventions
- Aortic Aneurysm Repair
Background:
- Traditional surgical repair of thoracoabdominal aortic aneurysms (TAAA) carries significant risks.
- Endovascular aneurysm repair (EVAR) requires suitable landing zones, often challenging in TAAA.
- Hybrid procedures combine open surgical techniques (debranching) with EVAR to address complex anatomy.
Observation:
- A patient with a 60 mm Crawford Type IV TAAA underwent a hybrid intervention.
- The procedure involved an aorto-splenic artery bypass with oversewing of the celiac trunk.
- An endograft was deployed to exclude the aneurysm four days later.
Findings:
- The hybrid repair was technically successful and well-tolerated by the patient.
- One-year follow-up showed excellent endograft position, no endoleak, and aneurysm involution.
- The aorto-splenic artery bypass remained patent, ensuring splenic viability.
Implications:
- Hybrid repair is a viable and less invasive option for TAAA, especially in high-risk patients.
- Debranching techniques enable successful endografting in anatomically challenging aortic segments.
- This case represents the first thoracoabdominal hybrid surgery performed in Hungary, expanding treatment options.
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