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<h2>Principles of Aortic Aneurysm Treatment </h2>
In general, treatment of the aorta begins with addressing the segment closest to the heart. Priority is also given to the section that is at risk of rupture, which is usually the symptomatic area or the segment with the largest diameter. 
Before treatment, patients typically undergo a CT scan to fully visualize the pathology of the aorta. This allows physicians to plan the treatment in a step-by-step manner. In some cases, multiple areas may be treated simultaneously, or treatment may be staged depending on what is most appropriate. 
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<h2>Hybrid Treatment of the Aorta </h2>
There are several treatment options for aortic diseases, depending on the size, symptoms, cause, and location of the condition. In certain parts of the aorta, treatment with a covered stent graft may be appropriate, while in other locations, open surgery may yield better results. Therefore, physicians may choose a hybrid approach that combines both endovascular and open surgical techniques, planned in a stepwise manner, to achieve optimal treatment outcomes and ensure patient safety. 
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<h2>Individualized Treatment Approach </h2>
For example, a 69-year-old female patient presented with severe back pain and had a history of hypertension for over 10 years. A CT scan revealed an aortic dissection in the descending thoracic aorta extending into the abdominal cavity. It was also found that the infrarenal abdominal aorta was aneurysmal, measuring 5.3 centimeters in diameter. A coronary angiogram showed normal coronary arteries, and the patient had normal kidney function, allowing the next step in treatment to proceed. 
In this case, the physician first treated the thoracic aorta by placing a covered stent graft via the left femoral artery. After this procedure, the patient&#8217;s back pain improved; however, she developed severe abdominal pain. The doctor then performed open surgery to replace the abdominal aorta with a synthetic graft through an abdominal incision. Endovascular repair in the abdominal section was not suitable in this case because the infrarenal aorta had a dissection, separating the vessel wall into two layers. The surgery was successfully completed on the third day after the initial treatment, and the patient recovered well, being discharged from the hospital seven days post-surgery. 
A follow-up CT scan showed that the wall of the thoracic aorta had developed a thrombus, which reduced the risk of rupture. Blood flow to the abdominal organs was normal, and the abdominal pain had completely resolved after surgery. In summary, this complex aortic disease involving multiple segments was treated safely and effectively with minimal complications, thanks to a well-planned hybrid treatment strategy combining both standard approaches in a carefully sequenced manner.

Aortic aneurysm treatment requires a personalized approach, often combining open surgery and endovascular techniques. Careful planning, including CT imaging, helps determine the safest, most effective sequence for repair—especially in complex cases involving multiple aortic segments. A hybrid treatment strategy can significantly improve outcomes, as demonstrated in a case of a 69-year-old patient who recovered well after staged interventions. 

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