Abstract
Case: A 77-year-old dialysis patient. Debranching TEVAR (Thoracic endovascular aortic repair, fenestrated stent grafting 42 mm, 38 mm) of the left common carotid artery and left subclavian artery was performed for an approximately 7×8.5 cm saccular aneurysm. After surgery, due to enlargement of the aortic aneurysm by a type III endoleakage, dissection of the ascending aorta and a bypass occlusion of the left common carotid artery, reoperation was performed. The proximal stent graft was removed and the distal stent graft was left in place because no type Ib endoleakage was found and therefore, a total replacement of the aortic arch and reconstruction of the left common carotid artery were done. TEVAR was less invasive and dramatically improved surgical mortality. However, due to additional treatments for endoleakages, semipermanent imaging monitoring is necessary. Thus, it seems to be important to think that treatment must be performed with consideration of the fact that mortality increases once a reoperation is decided.
