[Step-by-step endovascular repair for thoracoabdominal aortic aneurysm]

Area of Science:

• Vascular Surgery
• Endovascular Interventions
• Aortic Aneurysm Treatment

Background:

• A patient with myelodysplastic syndrome and pancytopenia presented with complex aortic aneurysms.
• Initial endovascular repair of abdominal aortic aneurysm was followed by new aneurysms in the iliac and thoracic aorta.

Observation:

• A type 1A endoleak and thoracic aortic aneurysm enlargement were detected a year after secondary surgery.
• The patient's comorbidities and aortic anatomy precluded standard stenting for endoleak exclusion.

Findings:

• Successful endovascular thoracoabdominal aortic repair was achieved using a T-branch device and a physician-modified stent graft.
• The repair maintained visceral artery perfusion and connected to previously implanted iliac components.
• Additional stenting of the descending aorta was performed to complete the aortic reconstruction.

Implications:

• Complex endovascular multilevel aortic reconstruction can be a successful alternative to open surgery in high-risk patients.
• This approach offers a less invasive option for treating extensive aortic disease in patients with significant comorbidities.
• Successful management highlights the adaptability of endovascular techniques for challenging aortic pathologies.