Related Experiment Video
Updated: May 11, 2026
Novel and Innovative Hybrid Technique for Type A Aortic Dissection
Published on: March 28, 2025
Hemiaortic arch debranching using native supra-aortic vessels
Joseph Touma1, Rabih Houbballah, Max Wohlauer
1Service de Chirurgie Vasculaire, Hôpital Henri Mondor, University of Paris, XII, Créteil, France.
Insights
A novel hybrid technique for aortic arch aneurysms avoids prosthetic material and shunts by transposing the left carotid and subclavian arteries. This approach simplifies endovascular repair in zone I, enhancing patient safety and outcomes.
Area of Science:
- Cardiovascular Surgery
- Vascular Endovascular Therapy
- Aortic Aneurysm Repair
Background:
- Endovascular repair of aortic arch aneurysms with proximal landing zones in zone I typically necessitates a carotid-carotid bypass.
- This standard procedure often involves prosthetic materials and may require bilateral carotid clamping, posing risks to cerebral perfusion.
Observation:
- Two patients with aortic arch aneurysms presented with challenging anatomy requiring zone I landing zones.
- A novel hybrid endovascular approach was employed, involving the transposition of the left common carotid artery and left subclavian artery to the right common carotid artery.
Findings:
- This innovative technique successfully utilized native vessels, eliminating the need for prosthetic bypass grafts.
- Cerebral perfusion was maintained throughout the procedure without the requirement for shunts or bilateral carotid clamping, simplifying the surgical process.
Implications:
- This hybrid approach offers a potentially safer and more efficient alternative for endovascular aortic arch aneurysm repair in zone I.
- It highlights the potential of utilizing native vasculature to overcome anatomical challenges and reduce procedural complications.
Abstract:
Endovascular treatment of aortic arch aneurysms with a proximal landing zone in zone I requires carotid-carotid bypass. We report two patients with aortic arch aneurysms in whom we used a new hybrid approach by transposing the left common carotid artery and left subclavian artery to the right common carotid artery. This innovative technique uses a native vessel instead of prosthetic material and a shunt to maintain cerebral perfusion, thereby avoiding bilateral carotid clamping.
