Introduction and objectives:

aortic arch and descending thoracic aorta repair are associated with a high morbidity and mortality. The frozen elephant trunk combined with TEVAR could improve outcomes. The objective is to describe short and midterm results of the hybrid approach in this pathology.

Material and methods:

retrospective analysis of patients who underwent two-staged intervention with hybrid prosthesis and TEVAR for aortic arch and thoracic descending aneurysm between August 2009 and February 2020.

Results:

thirteen patients were included, all of them secondary to non-dissecting aneurysm. First-stage intervention with frozen elephant trunk (average prosthesis diameter: 30 mm [29-33] average length: 130 mm). Supraaortic vessel reimplantation was performed most frequently (69 %) with an island technique for innominate artery and left common carotid artery and a left subclavian artery bypass to the aortic graft.

The average time to TEVAR implantation was 13.5 weeks (6-20), with technical success of 100 %. A single device was implanted in 9 cases, with 10 % oversizing relative to the hybrid prosthesis. No cases of paraplegia, stroke or perioperative death were observed. The average hospital stay length was 4 days (2-6) and the average follow-up after TEVAR was 17 months (9-25), survival at 24 months was 100 %. Correct aneurysm exclusion was documented in all CT controls, with no high-flow endoleaks during follow-up.

Conclusions:

based on our experience, TEVAR is a safe option as a second-stage intervention for complex thoracic aortic aneurysm pathology, offering excellent mid-term results for aneurysm exclusion.

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