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首页> 外文期刊>gefasschirurgie >Hybrid aortic procedures for endoluminal arch replacement
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Hybrid aortic procedures for endoluminal arch replacement

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Patients with pathologies involving the aortic arch are considered to be a challenge for vascular and cardiovascular surgeons. Conventional open aortic arch replacement using extra-corporal circulation, selective antegrade cerebral perfusion and deep hypothermia is associated with a high morbidity and mortality in high risk patients. Aortic arch hybrid procedures combine supraaortic debranching procedures to create a sufficient proximal landing zone with an endovascular stent graft placement to exclude the aortic arch pathology. Midterm results with a 30-day mortality rate of less than 10, a stroke rate of 3 and 1-year survival rate of 85 prove hybrid arch procedures to be an attractive alternative treatment modality for aortic arch pathologies, especially in high risk patients. Long term results are still missing. Until further developments in branched endograft technology arise, hybrid procedures offer an additional surgical approach for high risk patients, especially in emergencies. In summary, thoracic endografts can safely be used to treat a wide variety of thoracic aortic diseases including the arch, but long term data are needed to validate their use (evidence level III/B).

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