• Vascular Annual Meeting
• Call for Abstracts
• General Information
• Exhibitor Information
• Alumni Association Information
• 2009 Meeting Information
• Future Meeting Dates
• Contact Us

Home > Vascular Annual Meeting > VS7. Combined Endovascular and Surgical (Hybrid)...

VS7. Combined Endovascular and Surgical (Hybrid) Repair of a Thoracoabdominal Aneurysm

William J. Quinones-Baldrich
David Geffen School of Medicine at UCLA, Los Angeles, CA

OBJECTIVES: Present the key elements of a two-stage combined endovascular and surgical (hybrid) repair of a thoracoabdominal aneurysm.

METHODS: A 74-year-old male with a 7-cm type III thoracoabdominal aneurysm, a 6-cm
infrarenal aneurysm and severe COPD underwent a two-stage hybrid repair. The first stage involved infrarenal abdominal aortic aneurysm repair, retrograde revascularization of visceral vessels, and subcutaneous conduit placement. The repair was completed at second stage by placement of thoracoabdominal aortic endografts from the proximal descending thoracic aorta to the infrarenal aortic graft using the previously constructed conduit. Using two video cameras, the key elements are presented including preoperative planning, technique for proximal anastomoses to an ectatic infrarenal aorta, graft design and construction, exposure of visceral vessels at their origin, retrograde graft routing and coverage, and conduit placement, thrombectomy and use. Overlay video editing is used to highlight specific components of the procedure.

RESULTS: The key elements of a combined endovascular and surgical repair of a
thoracoabdominal aneurysm are highlighted in a 5-minute video.

CONCLUSIONS: Combined endovascular and surgical repair for thoracoabdominal aortic aneurysm has emerged as an alternative for high risk patients. Vascular surgeons, with experience in both surgical and endovascular techniques, are the specialists who can offer this alternative and should be familiar with the specific elements of this approach.

AUTHOR DISCLOSURES: W.J. Quinones-Baldrich, W.L. Gore.