Hybrid repair of thoracoabdominal aortic aneurysms: still a role?

The management of thoracoabdominal aortic aneurysms (TAAAs) has evolved from traditional open surgery to endovascular approaches, offering reduced operative times, shorter hospital stays, and lower perioperative morbidity and mortality. Fenestrated and branched endovascular aortic repair (FB-EVAR) has expanded the applicability of endovascular techniques to complex aneurysms. Hybrid repair, combining open surgical debranching with endovascular stent grafting, was introduced as an alternative for patients unsuitable for open or fully endovascular repair. However, outcomes from high-volume centers and national registries indicate significant mortality and morbidity rates associated with hybrid procedures. This article summarizes indications, technical aspects and outcomes of hybrid repair of complex abdominal and thoracoabdominal aortic aneurysms.