ArticleJournal of thoracic disease2026
Debranching with thoracic endovascular aortic repair for treating aortic arch lesions: a retrospective single-center experience.
Article in Journal of thoracic disease, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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6 authors.
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Abstract
Background: Hybrid aortic arch repair combining debranching surgery with thoracic endovascular aortic repair (TEVAR) addresses complex aortic arch lesions. This study evaluated the long-term outcomes of hybrid aortic arch repair combining debranching surgery with TEVAR. Methods: We retrospectively analyzed 41 consecutive patients (mean age 56.9±14.6 years) undergoing hybrid arch repair between January 2010 and January 2021. Lesions included aneurysms (n=17), dissections (n=21), penetrating aortic ulcers (n=2), and intramural hematomas (n=1). Patients were stratified by proximal landing zones: zone 0 (n=8), zone 1 (n=12), and zone 2 (n=21). Primary endpoints were technical success, 30-day mortality, and long-term survival. Secondary endpoints included endoleak rates, bypass patency, and major complications. All patients underwent simultaneous hybrid surgery. Results: Technical success was achieved in all cases (100%). Early complications included type I endoleaks (4.8%, managed conservatively), severe pneumonia (14.6%), and incision hematomas (9.8%). The 30-day mortality was 2.4% (1/41, myocardial infarction). During a mean follow-up of 62.6 months, bypass graft occlusion occurred in 5 patients (4/5 axillary, 1/5 subclavian grafts, 12.8%). The 1-, 3-, and 5-year survival rates were 94.9%, 92.3%, and 84.6%, respectively, with no significant differences among landing zones (P=0.72). Axillary bypasses showed inferior patency compared to carotid-based reconstructions. Conclusions: Hybrid arch repair achieves favorable long-term outcomes with low mortality and stroke rates. Anatomical landing zone selection did not affect survival, but axillary bypasses demonstrated poorer durability. These findings support hybrid strategies for high-risk patients, with preferential use of carotid-based reconstructions to optimize bypass longevity.
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