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Updated: Jun 14, 2026

Modified Octopus Technique for Thoracoabdominal Aortic Aneurysm
Published on: August 1, 2025
Thoracic endograft for abdominal aortic aneurysms, an unusual application for severe neck angulation: case report and
Roberto Silingardi1, Sebastiano Tasselli, Stefano Gennai
1Department of Vasular Surgery, Nuova Ospedale S. Agostino Estense, Modena. Italy.
Abstract:
Our goal was to achieve complete proximal sealing in severe aortic neck angulation (SNA) during endovascular aneurysm repair (EVAR) of a patient with an abdominal aortic aneurysm (AAA) unfit for surgery. An 82-year-old patient with an infrarenal AAA of 9.8 cm with an SNA of 90 degrees was admitted for acute coronary syndrome. Following coronary treatment, the patient was considered unfit for surgery and therefore was evaluated for EVAR. Aneurysm sac exclusion was obtained with the deployment of a Powerlink bifurcated graft (Endologix Inc, Irvine, CA) inside a Relay thoracic endograft (Bolton Medical, Florida) placed just below the most distal renal artery. At 6 months, computed tomographic angiography confirmed correct graft placement, complete aneurysm exclusion, and a reduction in the aneurysmal sac. In AAA patients with an SNA at high risk of EVAR failure, the adaptability of a thoracic endograft could be considered for proximal sealing.
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