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Updated: Jan 27, 2026
Modified Octopus Technique for Thoracoabdominal Aortic Aneurysm
Published on: August 1, 2025
Use of the Octopus Technique for Endovascular Treatment of Complex Aortic Lesions
Ming-Yi Hsu1, Ta-Wei Su2, I-Hao Su3
1Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital at Linkou, and Chang Gung University, Taoyuan, Taiwan; Department of Mechanical Engineering, Chang Gung University, Taoyuan, Taiwan.
Insights
The octopus endograft technique is feasible for treating complex aortic aneurysms (CAAs) with difficult anatomy. However, this complex aortic aneurysm repair carries significant risks, including high morbidity and mortality rates, requiring further study.
Area of Science:
- Vascular Surgery
- Endovascular Interventions
- Aortic Aneurysm Repair
Background:
- Complex aortic aneurysms (CAAs) present significant treatment challenges.
- Traditional open repair methods carry high risks.
- Endovascular techniques offer potential alternatives for managing CAAs.
Purpose of the Study:
- To evaluate the feasibility and effectiveness of the octopus endograft technique for treating complex aortic aneurysms (CAAs).
- To assess the safety and early outcomes of this technique in patients with challenging aortic pathologies.
Main Methods:
- A single-center study from June 2014 to June 2017 involved endovascular repair of CAAs using the octopus technique.
- The technique involved standard aortic grafts with branch stent grafts to preserve major side branches, including renovisceral arteries.
- Eleven patients with various CAAs, including thoracoabdominal aneurysms (TAAAs) and dissections, were included.
Main Results:
- The technical success rate for target vessel stent placement was 89.7% (35/39).
- The major complication rate was 45.5% (5/11), including three deaths and one case of permanent paraplegia.
- The technique successfully excluded three mycotic aneurysms without endoleak, with a mean follow-up of 29 months.
Conclusions:
- The octopus technique is a feasible option for treating CAAs, especially in urgent cases or those with complex anatomy where custom devices are unavailable.
- The procedure is associated with substantial morbidity and mortality.
- Long-term durability of the octopus technique for complex aortic aneurysm repair requires further investigation.
Purpose:
To evaluate feasibility and effectiveness using the octopus endograft technique to treat complex aortic aneurysms (CAAs).
Materials And Methods:
Endovascular repair of CAAs, including thoracoabdominal aneurysms (TAAAs) and dissections involving major side branches, was performed at a single center from June 2014 to June 2017. Patients included 9 men and 2 women (mean age, 60.5 y; range, 40-89 y) were included. The octopus technique was applied using standard aortic grafts with branch stent grafts to preserve the renovisceral arteries.
Results:
Aortic pathologies comprised 3 mycotic aneurysms, 2 chronic dissections with acute rupture, 1 progressively enlarging chronic type B dissection, 1 acutely ruptured TAAA, and 4 unruptured TAAAs. Mean procedural and fluoroscopic times were 562 min (range, 324-840 min) and 183 min (range, 73-338 min), respectively. Three patients died within 1 month. Mean duration of follow-up was 26.3 months (range, 8-42 months) for remaining patients. Technical success rate of target vessel stent placement was 89.7% (35/39). Major complication rate was 45.5% (5/11), including 3 deaths, 1 permanent paraplegia, and 1 temporary paraplegia that resolved in 2 months. All 3 mycotic aneurysms with mean duration of follow-up of 29 months (range, 8-42 months) were excluded successfully without endoleak.
Conclusions:
The octopus technique is feasible for treatment of CAAs requiring urgent management or with difficult anatomy without the use of available custom-made or off-the-shelf branched devices. The procedure carries substantial morbidity and mortality and requires further investigation for its long-term durability.
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