Related Experiment Video
Updated: Oct 2, 2026
Modified Octopus Technique for Thoracoabdominal Aortic Aneurysm
Published on: August 1, 2025
Successful endografting with simultaneous visceral artery bypass grafting for severely calcified thoracoabdominal
Yoshiko Watanabe1, Shin Ishimaru, Satoshi Kawaguchi
1Second Department of Surgery, Tokyo Medical University, Japan.
Insights
This study shows endografting with a retrograde aortomesenteric bypass is a safe and effective treatment for severely calcified thoracoabdominal aortic aneurysms, avoiding complications like spinal cord ischemia.
Area of Science:
- Vascular Surgery
- Interventional Cardiology
Background:
- Severely calcified thoracoabdominal aortic aneurysms pose significant treatment challenges.
- Traditional open repair carries high morbidity and mortality risks.
Observation:
- Two cases of complex thoracoabdominal aortic aneurysms were treated using endografting.
- A retrograde aortomesenteric bifurcated bypass graft was employed to reconstruct visceral arteries.
- Evoked spinal cord potential monitoring and intercostal artery occlusion tests were performed to prevent spinal ischemia.
Findings:
- The endovascular procedure was successfully completed in both cases.
- No significant changes in evoked spinal cord potential were observed.
- No endoleaks or perioperative complications, including paraplegia, were reported.
Implications:
- This technique offers a less-invasive and feasible treatment option for challenging aortic pathologies.
- Minimizing the risk of spinal cord ischemia is crucial in thoracoabdominal aortic aneurysm repair.
- Further research may validate this approach for a broader patient population.
Abstract:
We present two cases of severely calcified thoracoabdominal aortic aneurysm treated by means of endografting with a retrograde aortomesenteric bifurcated bypass graft reconstructing the celiac axis and superior mesenteric artery. To avoid spinal ischemia, we monitored evoked spinal cord potential and performed an occlusion test of the intercostal arteries using a retrievable stentgraft. No change in evoked spinal cord potential was noted, and no endoleaks or complications, including paraplegia, were observed. This procedure is a feasible and less-invasive treatment for severely calcified thoracoabdominal aortic aneurysms.
