Akademik Veri Yönetim Sistemi
22st Congress of Turkish Society for Vascular and Endovascular Surgery 13th Congress of Turkish Society of Phlebology, Antalya, Türkiye, 6 - 09 Kasım 2025, cilt.34, sa.1, ss.271, (Tam Metin Bildiri)
Abstract Aim: Aortic aneurysms and dissections are associated with high mortality and morbidity. Conventional open surgery provides long term durability but carries significant perioperative risk, whereas endovascular approaches are limited by anatomical constraints. Hybrid repair, combining surgical debranching with endovascular stent-graft implantation, has been introduced as an alternative for complex aortic pathologies. This study aimed to present the early outcomes of patients who underwent hybrid treatment at our center. Material and Methods: Between 2020 and 2025, six male patients underwent hybrid repair at our institution. The mean age was 64.1 years (range 28–87). Patient characteristics, procedures performed, and early postoperative outcomes were retrospectively evaluated. Hybrid techniques included proximal and/or visceral debranching followed by thoracic endovascular aortic repair (TEVAR), with or without endovascular abdominal aortic repair (EVAR). Results: The first patient, an 87-year-old with thoracic and abdominal aortic aneurysms, underwent proximal debranching with TEVAR and EVAR and was discharged without complications.The second patient, a 64-year-old with aortic dissection, presented in the preoperative period with elevated acute phase reactants and positive blood cultures for coagulase-negative staphylococci. He also had a history of supracoronary ascending aortic replacement performed 7 years earlier due to type I aortic dissection. Following proximal and visceral debranching with TEVAR and EVAR, he initially stabilized but died on postoperative day 21 due to aspiration pneumonia.The third patient, a 64-year-old with thoracoabdominal aortic aneurysm, had a history of previous coronary artery bypass grafting, subsequent myocardial infarction with coronary stent implantation, and chronic kidney disease. He underwent visceral debranching and TEVAR but developed multiorgan failure and died on postoperative day 5.The fourth patient, a 77-year-old with aortic dissection, underwent proximal debranching and TEVAR and was discharged uneventfully. The fifth patient, a 67-year-old with type III dissection, underwent visceral debranching and TEVAR and recovered without complications. The sixth patient, a 28-year-old with non-A non-B dissection, underwent proximal debranching and TEVAR and was discharged without complications. Overall, early mortality occurred in two patients (33.3%), while four patients (66.7%) were discharged uneventfully. No neurological complications such as stroke or paraplegia were observed. Conclusion: Our six-patient series demonstrates that hybrid repair is a feasible alternative for complex aortic aneurysms and dissections, particularly in elderly patients and those with challenging anatomy. However, patients with significant preoperative risk factors are at increased risk of early mortality. The uneventful recovery observed in most patients supports the efficacy of this method. Larger series with longer follow-up are needed to further clarify patient selection and long-term durability. Keywords: Aortic aneurysm, aortic dissection, hybrid surgical procedures