학술대회 발표 연제 초록

Background : A hybrid procedure for thoracic aorta disease involving aortic arch consists of surgical extra-anatomic bypass of aortic arch branches to provide a suitable proximal landing zone and thoracic endovascular aortic repair (TEVAR) using stent-grafts. This kind of procedure is generally less invasive than aorta replacement surgery. Here we report our experience with a hybrid TEVAR procedure at a single center Methods: A single institution retrospective analysis included patients who underwent a hybrid TEVAR procedure between August 2008 and September 2011. Clinical and procedural characteristics, angiographic findings and early and midterm outcomes were analyzed Results:A total of 22 patients (age 69.4 짹 14.3 years;18 males) were treated with a hybrid procedure. Nineteen patients had aneurysm involving ascending aorta or arch and 3 patients had a dissection involving aortic arch. Nine (41%) patients underwent debranching and rerouting from ascending aorta to arch vessels, while 13 (59%) had carotid to carotid or carotid to subclavianbypass graft. Technical success was achieved in all patients. Immediate post-procedure angiography showed type I endoleak in 3 patients (14%). Major complications occurred in 5patients: Mortality occurred in 3 patients (14%) and there were 3 patients (14%) with stroke and two patients (9%) with paraplegia (3/22). Mean follow up duration was 345 짹 76 days and the survival rate was 80.2%. The re-intervention rate was 14% (3/22) and the causes were type I endoleak (2/22) and endotension (1/22). Conclusion: Hybrid TEVAR procedure showed high technical success rate and acceptable rate of complication. Therefore, it may represent an alternative option in the treatment of patients who are high risk for conventional open surgicalrepair.