Total Arch Debranching Thoracic Endovascular Aortic Repair Using Femoral Artery Inflow

Some patients with aortic arch aneurysm are ineligible for open repair because of excessive perioperative risk, and others may not be suited for total endovascular repair due to anatomic constraints. We herein report a case of aortic arch aneurysm in a 94-year-old woman. The patient underwent hybrid aortic arch repair consisting of total arch debranching using bilateral femoral artery inflow and thoracic endovascular aortic repair. The patient was discharged without complications and is in good condition with dependent ambulation at 14 months of follow-up. Although a careful selection of cases is highly recommended, the use of the femoral artery inflow for arch debranching is considered to be a viable rescue option for high-risk patients.