Tratamiento híbrido sobre la zona 0 del arco aórtico

Introduction. Aortic dissection and thoracic aortic aneurysms are considered to be serious conditions that affect a large number of patients. Traditional surgical repair entails the use of complex techniques with high morbidity and mortality rates, which become even higher when the disease affects the aortic arch retrogradely. An endovascular procedure can be performed on the aortic arch by associating supra-aortic trunk revascularisation techniques, with an acceptable rate of success in patients who, owing to their age or comorbidity, are not suitable candidates for conventional surgical repair. Case report. We report a case of hybrid (surgical and endovascular) treatment in a male patient with thoracic aortic aneurysm secondary to type B chronic dissection, with retrograde compromise of the aortic arch. Complete exclusion of the aneurysm was achieved, with patency of the visceral branches and a significant reduction in the major diameter at one year after treatment. No important complications were observed during the follow-up and the patient currently leads an active life. Conclusions. Hybrid treatment can be an effective alternative, with a lower rate of morbidity, than conventional surgery in high risk patients suffering from a pathology affecting the aortic arch. Further studies are needed to show the feasibility, morbidity and mortality rates, complications and duration of these techniques, since those that have been conducted to date included only very short series of selected cases. [ANGIOLOGÍA 2008; 60: 353-7]