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<p>Advances in thoracic endovascular aneurysm repair have opened a novel frontier for management of aortic arch pathologies in the last few decades, and the supra-aortic bypasses help in maintaining antegrade flow in the aortic branches in assistance to this endovascular procedure. A meagre literature is available on the subject in the contemporary world. We performed a case series analysis of 21 patients who underwent supra-aortic bypasses as a hybrid procedure in assistance to thoracic endovascular aneurysm repair for aortic arch pathologies at a tertiary care Vascular surgery center. Ishimaru’s aortic zone 2 was the most common aortic zone involved. Neck hematomas and chyle leak were the commonest complications seen in 14.2% and 19% patients, respectively. No permanent superior and recurrent laryngeal nerve palsy was observed. A reversible spinal cord ischemia was observed in two patients. Only one supra-aortic prosthetic bypass graft thrombosed over 1&#xa0;year follow-up period and required intervention. There were two mortalities including one patient who developed a stroke. The safety profile of supra-aortic bypasses as a hybrid procedure in supplementing endovascular management of aortic arch pathologies offers credible possibilities.</p>

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Supra-Aortic Debranching Procedures as an Epoch in the History of Endovascular Aortic Arch Surgery: A Case Series Analysis

  • 期刊论文

  • 发表日期：

    2025年2月15日

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  • Rohit Mehra,
  • Pranati Swain,
  • Vikram Patra,
  • Rishi Dhillan,
  • Shreyasi Jha

摘要

Advances in thoracic endovascular aneurysm repair have opened a novel frontier for management of aortic arch pathologies in the last few decades, and the supra-aortic bypasses help in maintaining antegrade flow in the aortic branches in assistance to this endovascular procedure. A meagre literature is available on the subject in the contemporary world. We performed a case series analysis of 21 patients who underwent supra-aortic bypasses as a hybrid procedure in assistance to thoracic endovascular aneurysm repair for aortic arch pathologies at a tertiary care Vascular surgery center. Ishimaru’s aortic zone 2 was the most common aortic zone involved. Neck hematomas and chyle leak were the commonest complications seen in 14.2% and 19% patients, respectively. No permanent superior and recurrent laryngeal nerve palsy was observed. A reversible spinal cord ischemia was observed in two patients. Only one supra-aortic prosthetic bypass graft thrombosed over 1 year follow-up period and required intervention. There were two mortalities including one patient who developed a stroke. The safety profile of supra-aortic bypasses as a hybrid procedure in supplementing endovascular management of aortic arch pathologies offers credible possibilities.