1. The first hybrid stent-grafting
procedure of thoracic aorta
(1991)
- successful follow-up for
23 years
Professor Nikolay VOLODOS,
Kalashnykova Yuliia
Kharkov, UKRAINE

2. HYBRID PROCEDURES
List of publications 2013-2014
• De Rango P., Cao P. et al. Aortic debranching and thoracic endovascular repair //
J. Vasc. Surg. – 2014. – Vol. 59, N 1. – P.107 - 114.
• Bavaria J., Vallabhajosyula P. et al. Hybrid approach in the treatment of aortic arch
aneurysms: postoperative and midterm outcomes // J. Thorac. Cardiovasc. Surg. – 2013. –
Vol. 145 (3 Suppl). – P. S85 - 90.
• Benedetto U., Melina G. et al. Current results of open total arch replacement versus hybrid
thoracic endovascular aortic repair for aortic arch aneurysm: a meta-analysis of
comparative studies // J. Thorac. Cardiovasc. Surg. – 2013. – Vol. 145. – P. 305 - 306.
• Lorii S., Clough R.E. et al. Hybrid repair of complex thoracic aortic arch aneurysm
pathology: long-term outcomes of extra-anatomic bypass grafting of the supra-aortic trunk
// Cardiovasc. Intervent. Radiol. 2013. – Vol.36. – P. 46 – 55.
• Preventza O., Aftab M., Coselli J.S. Hybrid techniques for complex aortic arch surgery //
Texas Heart Institute Journal. – 2013. – Vol.40, N 5. – P.568 – 571.
• Preventza O. et al. Deployment of proximal thoracic endograft in xone 0 of the ascending
aorta: treatment options and early outcomes for aortic arch aneurysms in high-risk
population // Eur. J. Cardiothorac. Surg. – 2013. – Vol.44, N3. – P.446 – 453.
• Cherny M. et al. Hybrid aortic arch repair // Ann. Cardiothorac. Surg. – 2013. – Vol.2, N3. –
P.372 – 377.
• Cherny M. et al. Transposition of the supra-aortic vessels before stent-grafting the aortic
arch and descending aorta // J. Thorac. Cardiovasc. Surg. – 2013. – Vol. 145. – P. S91 – 97.
• Vallabhajosyula P. et al. Type II arch hybrid debranching procedure // Ann. Cardiothorac.
Surg. – 2013. – Vol.2, N3. – P.378 – 386.
• Andersen N.D. et al. Results with an algorythmic approach to hybrid repair of the aortic
arch // J. Vasc. Surg. – 2013. – Vol. 57, N 3. – P.655 - 667.
• Etc.

3. The date of procedure
THE FIRST HYBRID PROCEDURE
FOR AORTIC ARCH ANEURYSM:
14 JUNE, 1991

4. THE FIRST HYBRID PROCEDURE
FOR AORTIC ARCH ANEURYSM:
JUNE, 1991
Volodos N.L.,
Karpovich I.P.,
Troian V.I., et al.
Clinical experience of the
use of self-fixing synthetic
prostheses // Angiologie. -
VASA. - 1991. Suppl.33. -
P.93-95.

5. SCHEMATIC DRAWING OF THE FIRST HYBRID
PROCEDURE WITH DEBRANCHING FOR
AORTIC ARCH ANEURYSM: JUNE, 1991

6. Delivery system for endovascular
part of hybrid procedure

7. SCHEMATIC DRAWING OF THE FIRST HYBRID
PROCEDURE WITH DEBRANCHING FOR
AORTIC ARCH ANEURYSM: JUNE, 1991

8. СT scan 10 years after the hybrid
procedure
• The position of the
endoprosthesis is
unchanged/stable

9. СT scan 23 years after the hybrid
procedure

10. Lower endUpper end
СT scan 23 years after the hybrid procedure

11. Internal carotid arteries and subclavian arteries
left right
Considerable asymmetry of linear flow velocity is not observed in
both internal carotid arteries and in both subclavian arteries

12. Vertebral arteries and basilar artery
left right basilar
Significant asymmetry in the linear velocity of anterior cerebral
arteries is not observed
In both vertebral arteries and in basilar artery blood flow velocity
has a value within the age norm

13. Autovenous shunt
anastomosis with LCCA with LSubA
Abdominal aorta

14. Conclusions:
• The endoprosthesis has been functioning well for the duration
of the whole time of follow-up – 23 years after hybrid
operation.
• The system of blood flow created in the result of debranching
provides normal blood flow of the brain and the upper body for
the duration of the long time.
• The combined (hybrid) method of endovascular-surgical
prosthetic repair of the aorta arch aneurysm in combination
with strengthening of the load zone is effective in terms of
long-term results.
• The method of a hybrid prosthetic repair of the aorta arch
aneurysm, being the most universal one from the point of view
of the most complicated anatomical variants of the aorta arch
aneurysm, should be perfected with taking into account the
newest achievements of endovascular technology, new
endoprostheses, new delivery systems for prevention such
complications as proximal dissection, stroke etc.
• Taking into account the fact that there are so many anatomical
variants of the aorta arch aneurysms, especially in cases with
multisegmental thoracic aortic pathologies one can be sure
that this method will be in demand as a real clinical practice.