Hybrid Therapies for the Management of Aortic Dissection: Bridging Open Surgery and Endovascular Innovation

Abstract

Aortic dissection is a life-threatening condition characterized by the separation of the layers within the aortic wall, leading to a false lumen with the potential for severe complications, including rupture, malperfusion, and death. The management of aortic dissection has evolved significantly, with hybrid therapies emerging as a promising approach, particularly for complex cases involving extensive aortic involvement or high surgical risk. Hybrid therapies combine open surgical techniques with endovascular interventions to optimize outcomes by leveraging the strengths of both modalities. This article provides a comprehensive review of the current state of hybrid therapies in aortic dissection management, including their indications, technical considerations, and clinical outcomes. We explore the role of hybrid procedures in both acute and chronic phases of aortic dissection, focusing on scenarios such as aortic arch and thoracoabdominal involvement. Additionally, we discuss patient selection criteria, advances in imaging for procedural planning, and the challenges of long-term surveillance. By synthesizing recent evidence, we aim to highlight the potential of hybrid approaches to improve survival and reduce morbidity in this complex patient population.