Ten Years of Endovascular Aortic Arch Repair

Purpose: To evaluate a 10-year single-center experience of arch endovascular aortic repair (AEVAR) using the hybrid approach. Methods: Between 1999 and 2009, 311 patients were treated with endografts for thoracic aortic pathologies. The aortic arch was involved in 116 (37.3%) patients (97 men; mean age 70.3610.7 years, range 27–84). There were 83 atherosclerotic aneurysms, 21 type B dissections, and 12 other lesions whose proximal landing zones were categorized according to Ishimaru’s classification as 24 zone 0, 27 zone 1, and 65 zone 2. A hybrid approach was performed for all zone 0 and zone 1 procedures and in nearly half (47.7%) of zone 2 procedures. Early and midterm outcomes were reviewed retrospectively. Results: The initial clinical success in zone 0 aneurysms was 83.3%, with a 30-day mortality of 12.5 % due to intraoperative stroke in all the cases. The respiratory failure rate was 12.5%, and there was 1 type I endoleak that spontaneously resolved at follow-up. Midterm clinical success at a mean 26621 months was 83.3%. In zone 1 aneurysms, the initial clinical success was 82.1 % without 30-day mortality or perioperative stroke. The midterm clinical success was 81.5 % at a mean 21617 months [2 (7.4%