Endovascular Repair of Recurrent Thoracoabdominal Aortic Aneurysm

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Abstract
Purpose: To report the endovascular repair of a complicated, recurrent thoracoabdominal aortic aneurysm (TAAA) using stacked, customized stent-grafts. Case Report: A 75-year-old man was evaluated for an enlarging 7-cm suprarenal abdominal aortic aneurysm. The patient had repair of a distal TAAA in the past, as well as multiple visceral revascularizations from the infrarenal aorta. A 3-segment aortic endograft with proximal and distal extensions was delivered with the aid of a prosthetic conduit from the right common iliac artery to the end of the right renal artery; spinal fluid drainage was performed to mitigate paraplegia. The stent-graft components were serially deployed from the level of the left common carotid artery and ended with the bare springs of the distal extension covering the renal arteries. The patient was discharged but returned within a month for drainage of a purulent retroperitoneal hematoma. He has since resumed his preoperative activities and remains well with documented exclusion of the aneurysm and satisfactory visceral and distal perfusion at 21 months. Conclusions: This case illustrates that aortic endografting can be a viable option for the treatment of recurrent thoracoabdominal aortic aneurysms.