Abstract
We report a 59-year-old chronic hemodialysis patient with a thoracoabdominal aortic aneurysm, in whom the entire aortic wall and visceral branches were severely calcified. Using a staged operation approach, the celiac trunk and superior mesenteric artery were first bypassed with a composite graft made from a saphenous vein Y-graft and ePTFE. Next, we inserted a custom-made stent-graft, however, there was poor attachment at both the proximal and distal ends due to the severely calcified aortic wall. As a result, we used additional two stent-grafts. His postoperative course was good, and the CT scan performed one year after operation showed no endoleak.
