Abstract
A 77-year-old woman, given a diagnosis of descending aortic aneurysm with concomitant right lung cancer, was admitted to our hospital. Preoperative enhanced computed tomography (CT) scan demonstrated a saccular aortic aneurysm, 45 mm in diameter, in the left lateral wall of the descending aorta just above the diaphragm, and an ill-defined tumor, 31 mm in diameter, in the right lower lobe of the lung. Also, CT scan showed aneurysmal dilatation of the common iliac arteries and diffuse narrowing of the external iliac arteries. These findings indicated that it would be difficult to introduce a delivery system through the femoral or iliac artery if endovascular repair were attempted. Therefore, we performed an infrarenal aortic grafting in an end-to-side manner using a synthetic tube graft, and successfully completed endovascular repair of the descending aortic aneurysm though this aortic graft access. The right lung cancer was subsequently radically resected. Our procedure offers another possible access to facilitate endovascular repair of aortic aneurysm in patients without a proper anatomic iliofemoral access.
