Hybrid open-endoluminal technique for repair of thoracoabdominal aneurysm involving the celiac axis

Purpose: To describe a technique combining endoluminal and open approaches for the repair of thoracoabdominal aneurysms involving the celiac axis. Case Report: Two patients with type I thoracoabdominal aneurysm and subopti mal cardiac reserve underwent transluminal stent-graft implantation. To ach ieve satisfactory distal seal, the caudal end of the endograft was circumsc ribed with a Dacron band that was sutured to the aorta and endograft throug h a midline incision. The patent celiac artery in both patients was ligated to stop retrograde filling of the aneurysm sac. The patients developed no problems perioperatively, and exclusion of the aneurysms was confirmed by f ollow-up imaging. Three years after endografting, both patients had exclude d aneurysms without evidence of endoleak or device migration. Conclusions: This combined approach is another treatment option for thoraci c aneurysms that have an anatomically suitable proximal attachment zone wit h a compromised distal neck.