Hybrid aortic arch repair in high-risk patients is associated with a relevant morbidity, mortality, and reintervention rate. Patient selection is crucial and indication should be limited to patients not suitable for conventional aortic arch repair or emergency cases at present. Therefore, we recommend performing HAR only in high-volume centers with cardiovascular surgical cooperation.

Early results of visceral hybrid repair for high-risk patients with complex and extended TAAAs and CEADs are encouraging in a selected group of high risk patients in whom open repair is hazardous and branched endografts are not yet optional.

By using a selective approach to the LSA revascularization, coverage of the LSA can be used to extend the proximal seal zone for TEVAR without increasing the risk of spinal cord ischemia or stroke. Indications for revascularization include long segment aortic coverage, prior or concomitant infrarenal aortic replacement, and renal insufficiency. In addition, a hypoplastic right vertebral artery, a patent left internal mammary artery graft, and a functioning dialysis fistula in the left arm would also be indications to perform revascularization.

From different FEA derived parameters, PWRI distinguishes most precisely between asymptomatic and symptomatic AAAs. If elevated, this value may represent a negative prognostic factor for asymptomatic AAAs.

No abstract

These early results of visceral hybrid repair for high-risk patients with complex thoraco-abdominal aortic aneurysms are encouraging, in a group of patients in whom fenestrated/branched stent-grafting is not an option and open surgery hazardous.

Endovascular treatment of penetrating aortic ulcers is associated with a relevant morbidity and mortality rate in frequently highly comorbid patients. Midterm results could prove a sustained treatment success regarding actuarial survival and aortic-related death. Emergencies show a significantly worse outcome, but treatment is still warranted in these symptomatic patients.

TEVAR in patients with connective tissue diseases is feasible but still questionable regarding their young age and the rates of endoleaks and reintervention due to disease progression. Close surveillance is mandatory. Low morbidity and mortality rates may justify TEVAR in emergencies as a "bridging" method.