[Three staged operation for aneurysms of abdominal thoracoabdominal and aortic arch]

Sixty-one year old man, who was diagnosed as abdominal and thoracoabdominal aortic aneurysms, underwent only Y graft replacement for abdominal aortic aneurysm. Two years later, the graft replacement was carried out for the thoracoabdominal aortic aneurysm. Three years after the second operation, graft replacement of the aortic arch was performed under separate cerebral perfusion technique as a supportive measure, because of the gradual growth of the arch aneurysm. We recommend the distal aneurysm (abdominal aortic aneurysm) should be removed first to prevent the detachment of the thrombus in the aneurysm during proximal operation.