Four Different Pathologic Conditions of the Descending Aorta - One Hybrid Solution: Thoracic Endovascular Aortic Repair with Partial Debranching of the Aortic Arch. A Series of 6 Cases
Horaţiu Moldovan, Lucian Câlmâc, Marian Broască, Maria Sabina Safta, Bogdan Severus Gaşpar, Claudia Nica, Andrada Guţă, Liliana Mirea, Cristian Voica, Costin Minoiu, Aida Badea, Elena Nechifor, Silvia Preda, Mircea Robu, Alexandru Zăman, Andrada BogdanBrief report, no. 3, 2025
Article DOI: 10.21614//chirurgia.3066
Introduction: We report our experience of six patients admitted to our hospital during January - July 2023 with complex aortic conditions treated with a two-stage hybrid procedure, consisting of surgical debranching - bypass grafting - of the supra-aortic branches off-pump and stent graft placement for Thoracic Endovascular Aortic Repair (TEVAR).
Clinical features: The clinical cases we present highlight the use of TEVAR in both chronic (Type B aortic dissections, pseudoaneurysms, and penetrating aortic ulcers) and acute conditions (traumatic aortic transections and ruptured aortic aneurysms). TEVAR is a less invasive surgical approach for management of these critical patients, having as benefits: smaller incisions, avoiding operative risks associated with the classical procedure, shorter recovery time after the intervention and lower hospitalization costs.
Conclusions: TEVAR offers an alternative to open surgery, showing better immediate and mid-term results, as well as providing the chance to solve a variety of both chronic and acute cases that would be otherwise classified as too high risk for classic open surgery.
Clinical features: The clinical cases we present highlight the use of TEVAR in both chronic (Type B aortic dissections, pseudoaneurysms, and penetrating aortic ulcers) and acute conditions (traumatic aortic transections and ruptured aortic aneurysms). TEVAR is a less invasive surgical approach for management of these critical patients, having as benefits: smaller incisions, avoiding operative risks associated with the classical procedure, shorter recovery time after the intervention and lower hospitalization costs.
Conclusions: TEVAR offers an alternative to open surgery, showing better immediate and mid-term results, as well as providing the chance to solve a variety of both chronic and acute cases that would be otherwise classified as too high risk for classic open surgery.
Keywords: Thoracic Endovascular Aortic Repair (TEVAR), distal surgical debranching, blunt traumatic thoracic aortic injury, traumatic rupture of aortic isthmus; pseudoaneurysm, type B aortic dissection, penetrating aortic ulcers
