1. Results with an algorithmic approach to hybrid repair of the aortic arch 
Nicholas D. Andersen, MD, Judson B. Williams, MD, MHS, Jennifer M. Hanna, MD, MBA, Asad A. Shah, MD, Richard L. McCann, MD, G. Chad Hughes, MD 
Journal of Vascular Surgery 
Volume 57, Issue 3, Pages (March 2013)
DOI: /j.jvs
Copyright © 2013 Society for Vascular Surgery Terms and Conditions

2. Fig 1
Algorithm for hybrid aortic arch repair. *These criteria are relative factors in the decision-making process, not absolute indications or contraindications. Ideally, the decision for conventional vs hybrid repair should be made by a surgical team with expertise in both techniques. Institutional results with each approach should further influence the decision-making process.
Journal of Vascular Surgery  , DOI: ( /j.jvs )
Copyright © 2013 Society for Vascular Surgery Terms and Conditions

3. Fig 2
Zone 1 hybrid arch repair. In the case depicted, the carotid-carotid bypass graft was extended to revascularize the left subclavian artery, and the proximal left subclavian artery was occluded with an AMPLATZER vascular plug (St. Jude Medical Inc, St. Paul, Minn) to prevent type II endoleak.
Journal of Vascular Surgery  , DOI: ( /j.jvs )
Copyright © 2013 Society for Vascular Surgery Terms and Conditions

4. Fig 3
Native zone 0 hybrid arch repair. A, Initial construction of a left carotid-subclavian bypass allows uninterrupted left cerebral blood flow during left common carotid artery debranching. B, Following arch debranching, the endograft is deployed with native ascending aorta proximal landing zone. The arch debranching graft used incorporates an integral limb just above the inflow anastomosis to allow for antegrade endograft delivery without the need for femoral exposure. This limb is oversewn after completion of the procedure.
Journal of Vascular Surgery  , DOI: ( /j.jvs )
Copyright © 2013 Society for Vascular Surgery Terms and Conditions

5. Fig 4
Dacron zone 0 hybrid arch repair with ascending aorta and hemiarch replacement. A, In the first-stage procedure, ascending aorta and hemiarch replacement are performed followed by arch debranching from the newly constructed Dacron ascending aorta. B, Endografting is performed during a second procedure with the Dacron ascending aorta serving as proximal landing zone. In the case depicted, a left carotid-subclavian bypass was performed during the second-stage procedure to revascularize the left subclavian artery, and the proximal left subclavian artery was occluded with a vascular plug to prevent type II endoleak.
Journal of Vascular Surgery  , DOI: ( /j.jvs )
Copyright © 2013 Society for Vascular Surgery Terms and Conditions

6. Fig 5
Total arch replacement with staged stented elephant trunk completion. A, First-stage procedure involves total arch replacement using a modified Mt. Sinai technique. B, Second-stage procedure involves endovascular completion with the elephant trunk graft serving as proximal landing zone. Note the radiographic markers, hemoclips, and pacing wires on the elephant trunk graft.3
Journal of Vascular Surgery  , DOI: ( /j.jvs )
Copyright © 2013 Society for Vascular Surgery Terms and Conditions

7. Fig 6
Kaplan-Meier estimates of survival by procedure type. N, Number at risk; SE, standard error; SET, stented elephant trunk. *Time point at which SE exceeds 10%.
Journal of Vascular Surgery  , DOI: ( /j.jvs )
Copyright © 2013 Society for Vascular Surgery Terms and Conditions