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Ehsan Benrashid, MD, Hanghang Wang, MD, Nicholas D

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1 Complementary roles of open and hybrid approaches to thoracoabdominal aortic aneurysm repair 
Ehsan Benrashid, MD, Hanghang Wang, MD, Nicholas D. Andersen, MD, Jeffrey E. Keenan, MD, Richard L. McCann, MD, G. Chad Hughes, MD  Journal of Vascular Surgery  Volume 64, Issue 5, Pages (November 2016) DOI: /j.jvs Copyright © 2016 Society for Vascular Surgery Terms and Conditions

2 Fig 1 Institutional algorithm for thoracoabdominal aortic aneurysm (TAAA) repair. These criteria are relative factors in the decision-making process and are not absolute indications or contraindications. The decision for open vs hybrid TAAA repair should be made by a joint vascular and cardiac 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 © 2016 Society for Vascular Surgery Terms and Conditions

3 Fig 2 Kaplan-Meier freedom from reintervention after hybrid vs open thoracoabdominal aortic aneurysm (TAAA) repair. Freedom from reintervention was significantly greater after open repair (P = .01). Journal of Vascular Surgery  , DOI: ( /j.jvs ) Copyright © 2016 Society for Vascular Surgery Terms and Conditions

4 Fig 3 Kaplan-Meier unadjusted overall survival by procedure type. Unadjusted long-term survival was significantly lower (P = .03) after hybrid vs open thoracoabdominal aortic aneurysm (TAAA) repair. Journal of Vascular Surgery  , DOI: ( /j.jvs ) Copyright © 2016 Society for Vascular Surgery Terms and Conditions

5 Fig 4 Aorta-specific survival by procedure type. On long-term follow-up, there was no difference in aorta-specific survival between hybrid and open thoracoabdominal aortic aneurysm (TAAA) repairs (P = .23). Journal of Vascular Surgery  , DOI: ( /j.jvs ) Copyright © 2016 Society for Vascular Surgery Terms and Conditions

6 Fig 5 Institutional procedural volumes by year for open thoracoabdominal aortic aneurysm repair (OTAAAR) and hybrid thoracoabdominal aortic aneurysm repair (HTAAAR) demonstrating a shift from a hybrid-predominant to an open-predominant strategy in the latter years of the series. Journal of Vascular Surgery  , DOI: ( /j.jvs ) Copyright © 2016 Society for Vascular Surgery Terms and Conditions

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