To describe a hybrid technique combining endovascular stent-graft implantation with open distal anastomosis for managing subclavian-axillary artery aneurysms in patients with Loeys-Dietz syndrome.
Approach:
Case 1 Presentation: A 42-year-old man with Loeys-Dietz syndrome underwent a two-staged approach for aortic arch repair and right subclavian artery aneurysm, utilizing a Frozen Elephant Trunk repair followed by a hybrid approach for the aneurysm.
Case 2 Presentation: A 63-year-old woman with extensive aneurysmal disease had a hybrid approach for aortic arch and left subclavian artery aneurysm repair, involving branched endovascular aortic arch repair and TEVAR.
Key Findings:
Both cases utilized a hybrid surgical approach to manage complex aneurysms in patients with Loeys-Dietz syndrome.
The hybrid technique allowed for targeted exclusion of aneurysmal segments while minimizing the physiological burden of open surgery.
Interpretation:
The hybrid approach may provide a viable option for managing subclavian-axillary artery aneurysms in high-risk patients with Loeys-Dietz syndrome.
Limitations:
The evidence regarding the safety, efficacy, and long-term outcomes of hybrid approaches in managing subclavian-axillary artery aneurysms in Loeys-Dietz syndrome is limited.
Conclusion:
The described hybrid technique demonstrates a potential strategy for managing complex aneurysms in patients with Loeys-Dietz syndrome, although further evidence is needed.
