Hybrid treatment of aortic arch aneurysms

The advent of thoracic aortic endovascular stent-grafting has drastically changed the management of thoracic aneurysms. In 1991, Volodos and colleagues performed the first hybrid aortic arch repair. The case involved an arch debranching with placement of an endograft in a patient with a previous repair for an aortic coarctation. Since that time, thoracic endografts have largely been incorporated into the treatment of aortic arch disease using hybrid approaches. In this article we will discuss the technical details of both the open and endovascular portion of hybrid aortic arch repairs. We will also review the evidence supporting the use of hybrid operations to repair aortic arch pathology, with a focus on mortality, morbidity and technical success.