Challenge of Treating Thoracoabdominal Aortic Aneurysms with Hybrid Thoracic Endovascular Aortic Repair

: The treatment of thoracoabdominal aortic aneurysms in great vessels is still challenging, as the early results of the operation are not very promising compared with other aortic operations, and the incidence of spinal cord ischemia is relatively high. In Japan, which is becoming a super-aging society, the method of performing minimally invasive operations remains a major issue. At our facility, we have been performing abdominal debranching thoracic endovascular aortic repair (TEVAR) to resolve these issues. Hybrid TEVAR was performed in 51 cases of aortic aneurysm and chronic dissection of the thoracoabdominal field between 2007 and 2015. The standard operative procedure of abdominal debranching involves replacing the abdominal aorta with a bifurcated graft and making an anastomosis between the left leg of the bifurcated graft and a quadrifurcated graft;the visceral arteries are then reconstructed using the quadrifurcated graft. Abdominal debranching and TEVAR were performed as a 2-stage procedure. Hybrid repair of a thoracoabdominal aortic aneurysm is a good option for elderly, high-risk patients because the early and late results are acceptable.