Skip to main content
SpringerLink
Log in

Hybrid Repair Using Visceral Debranching and Aortic Stent Grafts to Treat Complex Aortic Aneurysms

  • Chapter
  • First Online:
Endovascular Aortic Repair

Abstract

Hybrid repair or visceral debranching was introduced in 1999 as a means to reduce the physiologic stress associated with major open aortic reconstructions to treat thoracoabdominal aneurysms. The initial enthusiasm with the technique has been tempered by reports of high mortality rates in higher-risk patients. However, the technique has its value by avoiding a thoracotomy, minimizing ischemia time, and potentially decreasing need for catheter manipulations around the renal and mesenteric arteries, which can be dangerous in patients with severe atherosclerotic debris. This chapter summarizes the technical aspects of visceral debranching techniques.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 149.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 199.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 279.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Endovascular aneurysm repair versus open repair in patients with abdominal aortic aneurysms (EVAR Trial 1): randomized controlled trial. Lancet. 2005;365:2179–86.

    Google Scholar 

  2. Prinssen M, Verhoeven EL, Buth J, Cuypers PW, van Sambeek MR, Balm R, et al. A randomized trial comparing conventional and endovascular repair of abdominal aortic aneurysms. N Engl J Med. 2004;351:1607–18.

    Article  CAS  PubMed  Google Scholar 

  3. Coselli JS, Bozinovski J, LeMaire SA. Open surgical repair of 2286 thoracoabdominal aortic aneurysms. Ann Thorac Surg. 2007;83:S862–4.

    Article  PubMed  Google Scholar 

  4. Conrad MF, Crawford RS, Davison JK, Cambria RP. Thoracoabdominal aneurysm repair: a 20-year experience. Ann Thorac Surg. 2007;83:S856–61.

    Article  PubMed  Google Scholar 

  5. Jacobs MJ, van Eps RG, de Jong DS, Schurink GW, Mochtar B. Prevention of renal failure in patients undergoing thoracoabdominal aortic aneurysm repair. J Vasc Surg. 2004;40:1067–73.

    Article  PubMed  Google Scholar 

  6. Safi HJ, Estrera AL, Miller CC, Huynh TT, Porat EE, Azizzadeh A, et al. Evolution of risk for neurologic deficit after descending and thoracoabdominal aortic repair. Ann Thorac Surg. 2005;80:2173–9.

    Article  PubMed  Google Scholar 

  7. Rigberg DA, McGory ML, Zingmond DS, Maggard MA, Agustin M, Lawrence PF, et al. Thirty-day mortality statistics underestimate the risk of repair of thoracoabdominal aortic aneurysms: a statewide experience. J Vasc Surg. 2006;43:217–22.

    Article  PubMed  Google Scholar 

  8. Greenberg RK, Eagleton M, Mastracci T. Branched endografts for thoracoabdominal aneurysms. J Thorac Cardiovasc Surg. 2010;140:S171–8.

    Article  PubMed  Google Scholar 

  9. Rodd CD, Desigan S, Chesire NJ, Jenkins MP, Hamady M. The suitability of thoracoabdominal aortic aneurysms for branched and fenestrated stent grafts—and the development of a new scoring method to aid case assessment. Eur J Vasc Endovasc Surg. 2011;41:175–85.

    Article  CAS  PubMed  Google Scholar 

  10. Sweet MP, Hiramoto JS, Park KH, Reilly LM, Chuter TM. A standard multi-branched thoracoabdominal stent-graft for endovascular aneurysm repair. J Endovasc Ther. 2009;16:359–64.

    Article  PubMed  PubMed Central  Google Scholar 

  11. Ohrlander T, Sonesson B, Ivancev K, Resch T, Dias N, Malina M. The chimney graft: a technique for preserving or rescuing aortic branch vessels in stent-graft sealing zones. J Endovasc Ther. 2008;15(4):427–32.

    Article  PubMed  Google Scholar 

  12. Oderich GS, Fatima J, Gloviczki P. Stent graft modification with mini-cuff reinforced fenestrations for urgent repair of thoracoabdominal aortic aneurysms. J Vasc Surg. 2011 Nov;54(5):1522–6.

    Google Scholar 

  13. Quinones-Baldrich WJ, Panetta TF, Vescera CL, Kashyap VS. Repair of type IV thoracoabdominal aneurysm with a combined endovascular and surgical approach. J Vasc Surg. 1999;30(3):555–60.

    Article  CAS  PubMed  Google Scholar 

  14. Chaikof EL, Fillinger MF, Matsumura JS, Rutherford RB, White GH, Blakensteijn JD, et al. Identifying and grading factors that modify the outcome of endovascular aortic aneurysm repair. J Vasc Surg. 2002;35:1061–6.

    Article  PubMed  Google Scholar 

  15. Drinkwater SL, Goebells A, Haydar A, Bourke P, Brown L, Hamady M, et al. The incidence of spinal cord ischemia following thoracic and thoracoabdominal endovascular intervention. Eur J Vasc Endovasc Surg. 2010;40:729–35.

    Article  CAS  PubMed  Google Scholar 

  16. Lachat M, Mayer D, Criado FJ, Pfammatter T, Rancic Z, Genoni M, et al. New technique to facilitate renal revascularization with use of telescoping self-expanding stent grafts: VORTEC. Vascular. 2008;16(2):69–72.

    Article  PubMed  Google Scholar 

  17. Quinones-Baldrich W, Jimenez JC, DeRubertis B, Moore WS. Combined endovascular and surgical approach (CESA) to thoracoabdominal aortic pathology: a 10-year experience. J Vasc Surg. 2009;49:1125–34.

    Article  PubMed  Google Scholar 

  18. Patel HJ, Upchurch GR, Eliason JL, Criado E, Rectenwald J, Williams DM, et al. Hybrid debranching with endovascular repair for thoracoabdominal aneurysms: a comparison with open repair. Ann Thorac Surg. 2010;89:1475–81.

    Article  PubMed  Google Scholar 

  19. Resch TA, Greenberg R, Lyden SP, Clair DG, Krajewski L, Kashyap VS, et al. Combined staged procedures for the treatment of thoracoabdominal aneurysms. J Endovasc Ther. 2006;13:481–9.

    Article  PubMed  Google Scholar 

  20. Black SA, Wolfe JHN, Clark M, Harmady M, Cheshire NJW, Jenkins MP. Complex thoracoabdominal aortic aneurysms: endovascular exclusion with visceral revascularization. J Vasc Surg. 2006;43:1081-9.E HE.

    Google Scholar 

  21. Patel R, Conrad MF, Paruchuri V, Kwolek CJ, Chung TK, Cambria RP. Thoracoabdominal aneurysm repair: hybrid versus open repair. J Vasc Surg. 2009;50(1):15–22.

    Article  PubMed  Google Scholar 

  22. Chiesa R, Tshomba Y, Melissano G, Marone EM, Bertoglio L, Setacci F, et al. Hybrid approach to thoracoabdominal aortic aneurysms in patients with prior aortic surgery. J Vasc Surg. 2007;45(6):1128–35.

    Article  PubMed  Google Scholar 

  23. Drinkwater SL, Bockler D, Eckstein H, Cheshire NJ, Kotelis D, Wolf O, et al. The visceral hybrid repair of thoraco-abdominal aortic aneurysms—a collaborative approach. Eur J Vasc Endovasc Surg. 2009;38(5):578–85.

    Article  CAS  PubMed  Google Scholar 

  24. Lee WA, Brown MP, Martin TD, Seeger JM, Huber TS. Early results after staged hybrid repair of thoracoabdominal aortic aneurysms. J Am Coll Surg. 2007;205(3):420–31.

    Article  PubMed  Google Scholar 

  25. Lin PH, Kougias P, Bechara CF, Weakley SM, Bakaeen FG, LeMaire SA, Coselli JS. Clinical outcome of staged versus combined treatment approach of hybrid repair of thoracoabdominal aortic aneurysm with visceral debranching and aortic endograft. Perspect Vasc Surg Endovasc Ther. 2012;24(1):5–13.

    Article  PubMed  Google Scholar 

  26. Bakoyiannis C, Kalles V, Economopoulos K, Georgopoulos S, Tsigris C, Papalambros E. Hybrid techniques in the treatment of thoracoabdominal aortic aneurysms: systematic review. J Endovasc Ther. 2009;16:443.

    Article  PubMed  Google Scholar 

  27. Moulakakis KG, Mylonas SN, Avgerinos E, Kakisis J, Liapis CD. Hybrid open endovascular technique for aortic thoracoabdominal pathology. Circulation. 2011;124:2670.

    Article  PubMed  Google Scholar 

  28. Oderich GS, Farber M, Quinones-Baldrich W, Greenberg R, Upchurch G, Timaran C, et al. Preliminary results of the North American Complex Abdominal Debranching registry. Presented at the 2011 Vascular Annual Meeting, Chicago IL, June 18 2011.

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Division of Vascular and Endovascular Surgery, Department of Surgery, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA

    Gustavo S. Oderich

  2. Division of Vascular and Endovascular Surgery, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA

    Peter Gloviczki, Thomas C. Bower & Bernardo C. Mendes

  3. Division of Vascular and Endovascular Surgery, University of Arkansas for Medical Sciences, 4301 W Markham St. #520-2, Little Rock, AR, 72205-7199, USA

    Guillermo A. Escobar

Authors
  1. Gustavo S. Oderich
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Guillermo A. Escobar
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Peter Gloviczki
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Thomas C. Bower
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Bernardo C. Mendes
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Gustavo S. Oderich .

Editor information

Editors and Affiliations

  1. Division of Vascular and Endovascular Surgery, Department of Surgery, Mayo Clinic, Rochester, Minnesota, USA

    Gustavo S. Oderich

Rights and permissions

Reprints and permissions

Copyright information

© 2017 Mayo Foundation for Medical Education and Research

About this chapter

Cite this chapter

Oderich, G.S., Escobar, G.A., Gloviczki, P., Bower, T.C., Mendes, B.C. (2017). Hybrid Repair Using Visceral Debranching and Aortic Stent Grafts to Treat Complex Aortic Aneurysms. In: Oderich, G. (eds) Endovascular Aortic Repair. Springer, Cham. https://doi.org/10.1007/978-3-319-15192-2_31

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-15192-2_31

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-15191-5

  • Online ISBN: 978-3-319-15192-2

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation