Hybrid Procedures for Thoracoabdominal Aortic Aneurysms

Treatment of thoracic aortic pathology has been rapidly changing in the 5 years since US Food and Drug Administration approval of thoracic stent grafts. Although not specifically evaluated in any of the major clinical trials to date, adjunctive techniques are being increasingly used to expand the applicability of stent-graft technology to patients with more extensive thoracoabdominal aortic aneurysms and dissections. Details of procedural techniques have been delineated by several aortic specialists, resulting in a trend toward standardization of effective strategies. Despite this trend, significant variability is evident in the outcomes of reported series. The objective of this article is to analyze published reports of hybrid procedures involving complete visceral debranching of the aorta and endovascular exclusion of the thoracoabdominal aortic aneurysms.