Current results of open total arch replacement versus hybrid thoracic endovascular aortic repair for aortic arch aneurysm: A meta-analysis of comparative studies

For aortic arch aneurysm, conventional open total aortic arch replacement (OTAAR) has long been considered the standard therapy. Despite improvement of surgical technology and strategy, however, OTAAR remains a procedure associated with some morbidity and mortality, particularly among high-risk patients. In an attempt to reduce the complications associated with OTAAR, hybrid thoracic endovascular aortic repair (HTEAR), with aortic arch debranching end endovascular graft placement, has emerged as an attractive option for high-risk patients. Randomized controlled trial comparing the strategies are not available, however, and potential advantages of the hybrid strategy relative to the conventional procedure remain to be demonstrated. To gain insights into the role of the hybrid approach in the management of aortic arch aneurysm, we conducted a meta-analysis of available comparative studies.