Background

Thoracic aortic arch aneurysms (TAAs) can be a life‐threatening condition due to the potential risk of rupture. Treatment is recommended when the risk of rupture is greater than the risk of surgical complications. Depending on the cause, size and growth rate of the TAA, treatment may vary from close observation to emergency surgery. Aneurysms of the thoracic aorta can be managed by a number of surgical techniques. Open surgical repair (OSR) of aneurysms involves either partial or total replacement of the aorta, which is dependent on the extent of the diseased segment of the aorta. During OSR, the aneurysm is replaced with a synthetic graft. Hybrid repair (HR) involves a combination of open surgery with endovascular aortic stent graft placement. Hybrid repair requires varying degrees of invasiveness, depending on the number of supra‐aortic branches that require debranching. The hybrid technique that combines supra‐aortic vascular debranching with stent grafting of the aortic arch has been introduced as a therapeutic alternative. However, the short‐and long‐term outcomes of HR remain unclear, due to technical difficulties and complications as a result of the angulation of the aortic arch as well as handling of the arch during surgery.

Objectives

To assess the effectiveness and safety of HR versus conventional OSR for the treatment of TAAs.