Abstract
Endovascular treatment for aortic aneurysms carries a lower mortality than open surgery, especially for thoracic aortic aneurysms (TAA) which usually affect a high-risk patient population. Furthermore when the aneurysm is located in the aortic arch, the surgical approach presents additional problems such as recurrent laryngeal nerve and phrenic nerve lesions, cerebrovascular complications and pulmonary parenchymal damage. Nevertheless the endovascular approach, even if less invasive, can be difficult because of the curvature of the aortic arch and because of the need to keep the cerebral vessels open. This paper describes a combined approach, surgical and endovascular, where cerebral vessel reconstruction was carried out before endovascular surgery.
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