Hybride procedure; aorta; complex aortic surgery; aortic dissection; aortic aneurysm; aortic arch; visceral debranching

The use of hybrid techniques in the treatment of complex aortic artery diseases is based upon combination of surgical techniques, the advantage of which are verified good long-term results, and endovascular techniques, which are associated with a decrease of the surgical risk for the patient. These hybrid techniques are used for the treatment of thoracic aortic diseases in situations, when part of the aorta with significant branches, as well as adjacent part of the aorta without such branches, are affected with the pathological process. The most frequent scenario for the use of hybrid techniques thus is a combination of the aortic arch and descending aorta disease, or pathology of the descending aorta including abdominal part. Most frequently performed hybrid procedures in the area of thoracoabdominal aorta are arch debranching, stented elephant trunk, frozen elephant trunk and visceral debranching. In the following text, the principle and surgical technique are listed for every type of the procedure, together with main advantages and disadvantages. Also, we present a detailed analysis of treatment outcomes published in the literature. Due to the fact, that long-term outcomes are not known for any of these techniques on a representative patient cohort, they cannot be considered a method of first choice, and they do not replace a radical surgical resection procedure. Nevertheless, the presented procedures represent a new and perspective method, which broadens the possibilities of treatment of thoracic aortic diseases in patients, who are not suitable for radical surgical treatment.