Complex Aortic Aneurysm: A Current Indication for Debranching

Conventional open repair of thoracoabdominal aortic aneurysms is still associated with severe complications and shows immediate mortality rates up to 20%. Although there is an increasing number of cases treated exclusively by an endovascular approach, renovisceral debranching still represents a valid alternative in high-risk patients for open surgery and in those patients where endovascular procedures are not feasible due to anatomic limitations or are not available when patients cannot wait for treatment. Herein we report the case of a patient with multiple surgical interventions and an extensive aortic aneurysm, complicated with a chronic contained rupture of the renovisceral aorta, who was successfully treated by means of a hybrid technique involving renovisceral debranching after discarding a pure endovascular management due to anatomical criteria.