Hernando Thorne-Vélez, Departamento de Cirugía General, Hospital Serena del Mar, Fundación Santa Fe de Bogotá, Cartagena, Colombia
Carlos J. Pérez-Rivera, Departamento de Cirugía General, Universidad El Bosque, Bogotá, Colombia
William Daza-Reatiga, Departamento de Cirugía Vascular y Angiología, Clínica Altos de San Vicente, Barranquilla, Colombia
Axel Tosltano-Gleiser, Departamento de Cirugía Cardiovascular, Facultad de Medicina, Universidad Libre, Barranquilla, Colombia
Juan F. Victoria-Fernández, Departamento de Cirugía General, Facultad de Medicina, Universidad El Bosque, Bogotá, Colombia
Introduction: Thoracic endovascular aneurysm repair (TEVAR) is the preferred strategy for treating descending aortic disease. However, aortic arch involvement remains challenging, especially in proximal landing zones (0, 1, or 2) due to the presence of supra-aortic trunks. Hybrid techniques combining supra-aortic debranching with TEVAR offer an alternative to open surgery. Objective: To describe the experience and outcomes of patients undergoing supra-aortic debranching followed by TEVAR at a tertiary cardiovascular center in Colombia. Methods: A retrospective cohort study (2021–2023) including patients who underwent supra-aortic debranching followed by TEVAR was conducted. Clinical characteristics, procedural details, and outcomes, including complications, mortality, and reinterventions, were analyzed. Shapiro-Wilk, Kruskal-Wallis, and Chi-squared/ Fisher’s exact tests were used accordingly. Results: A total of 21 patients were included (mean age: 70.71 years, SD ±12.21). The most common comorbidities were chronic kidney disease (61.90%), diabetes (61.90%), and dyslipidemia (66.66%). The most frequently performed procedure was left subclavian-carotid debranching (52.38%). Major complications included pneumonia (52.38%), atrial fibrillation (28.57%), and myocardial infarction (38.09%). No mortality was reported at 6, 12, or 24 months. Conclusions: Supra-aortic debranching followed by TEVAR demonstrated high patency rates, technical success, and favorable survival outcomes. It remains a viable alternative in centers without access to advanced endovascular technologies.
Keywords: TEVAR. Supra-aortic debranching. Hybrid aortic repair. Thoracic aortic aneurysm. Vascular surgery. Carotid-subclavian bypass.
