Abstract
A 57-year-old man had undergone two thoracic endovascular aneurysmal repair (TEVAR) procedures using a handmade stent graft to treat an enlarged ulcer-like projection due to type B acute aortic dissection and complications (type I endoleakage and migration) after an initial TEVAR. This report describes an infrarenal abdominal aortic aneurysm (maximum size, 60 mm) accompanied by a type III endoleakage and a dilated descending thoracic aorta (48 mm) revealed by chest computed tomography. A strategy to treat both aortic pathologies was considered because multilevel aortic disease is associated with a high mortality rate. We believed that replacing the thoracic descending aorta would treat the endoleakage after TEVAR and that endovascular aneurysmal repair (EVAR) would treat the AAA. The patient underwent EVAR followed by thoracic descending aorta replacement two months later without any complications, such as paraplegia.
