{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,18]],"date-time":"2025-11-18T11:29:52Z","timestamp":1763465392108,"version":"3.45.0"},"reference-count":51,"publisher":"MDPI AG","issue":"11","license":[{"start":{"date-parts":[[2025,11,18]],"date-time":"2025-11-18T00:00:00Z","timestamp":1763424000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"University of Medicine and Pharmacy Carol Davila"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Life"],"abstract":"<jats:p>Pararenal abdominal aortic aneurysm\/pseudoaneurysms (PAAA\/PAAP) are rare, high-risk complex aortic lesions involving the renal arteries. Management includes open surgical repair (OSR), endovascular aortic repair (EVAR), or hybrid repair, each with specific advantages and limitations. A review of the literature was performed to assess treatment strategies and outcomes for PAAA and PAAP. A PubMed search using relevant MeSH terms identified 184 articles published in the last five years. After applying inclusion and exclusion criteria, 34 studies comprising 6460 patients with complex AAA\/AAP were included for analysis. Treatment strategies were predominantly endovascular (79.4%), followed by open (5.8%) and hybrid approaches (2.9%) (11.7% have used EVAR or OSR in the same study). To emphasize difficulties in the management of this pathology, a case report of a large PAAP involving both renal arteries and occluded celiac trunk with retrograde flow from patent superior mesenteric artery (SMA) is presented. Given the complex anatomy and high surgical risk, hybrid treatment was chosen consisting of bilateral ilio-renal Dacron bypasses followed by ChEVAR (chimney stenting of the SMA), with favorable postoperative recovery. The management of PAAP requires an individualized, anatomy- and risk-adapted approach. Open surgical repair remains preferable for younger, low-risk patients for superior long-term durability, whereas endovascular repair offers lower perioperative morbidity in high-risk cohorts. Optimal outcomes are dependent on high-volume centers with multidisciplinary expertise.<\/jats:p>","DOI":"10.3390\/life15111765","type":"journal-article","created":{"date-parts":[[2025,11,18]],"date-time":"2025-11-18T11:05:31Z","timestamp":1763463931000},"page":"1765","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Hybrid Open and Endovascular Repair in Pararenal Abdominal Aortic Pseudoaneurysm\u2014Literature Review and Case Presentation"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9069-2722","authenticated-orcid":false,"given":"Vlad Anton","family":"Iliescu","sequence":"first","affiliation":[{"name":"Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania"},{"name":"Department of Cardiovascular Surgery, \u201cProf. Dr. C.C. Iliescu\u201d Emergency Institute for Cardiovascular Diseases, 022328 Bucharest, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Reza","family":"Nayyerani","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania"},{"name":"Department of Cardiovascular Surgery, \u201cProf. Dr. C.C. Iliescu\u201d Emergency Institute for Cardiovascular Diseases, 022328 Bucharest, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Catalina Andreea","family":"Parasca","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania"},{"name":"Department of Cardiovascular Surgery, \u201cProf. Dr. C.C. Iliescu\u201d Emergency Institute for Cardiovascular Diseases, 022328 Bucharest, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pavel","family":"Platon","sequence":"additional","affiliation":[{"name":"Department of Interventional Cardiology, \u201cProf. Dr. C.C. Iliescu\u201d Emergency Institute for Cardiovascular Diseases, 022328 Bucharest, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Catalin","family":"Baston","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania"},{"name":"Department of Urology, Fundeni Clinical Institute, 022328 Bucharest, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bianca","family":"Morosanu","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania"},{"name":"Department of Anesthesia and Intensive Care, \u201cProf. Dr. C.C. Iliescu\u201d Emergency Institute for Cardiovascular Diseases, 022328 Bucharest, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ovidiu","family":"Stiru","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania"},{"name":"Department of Cardiovascular Surgery, \u201cProf. Dr. C.C. Iliescu\u201d Emergency Institute for Cardiovascular Diseases, 022328 Bucharest, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,11,18]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"192","DOI":"10.1016\/j.ejvs.2023.11.002","article-title":"Editor\u2019s Choice\u2014European Society for Vascular Surgery (ESVS) 2024 Clinical Practice Guidelines on the Management of Abdominal Aorto-Iliac Artery Aneurysms","volume":"67","author":"Wanhainen","year":"2024","journal-title":"Eur. J. Vasc. Endovasc. 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