One-year follow-up after total endovascular repair of a contained-ruptured thoracoabdominal aortic aneurysm with the sandwich technique

We report the case of a 68-year-old woman who was referred to our clinic due to a contained-ruptured type III thoracoabdominal aortic aneurysm 9 cm in diameter. The patient was not a candidate for an open repair because of her comorbid conditions, including dialysis, heart insufficiency requiring pacemaker support, chronic obstructive pulmonary disease, coronary artery disease, and previous abdominal aortic repair. Owing to her hemodynamic instability, we performed a totally endovascular repair with off-the-shelf devices by means of the sandwich technique. An intraoperative gutters-associated endoleak occurred but resolved after 2 months. The 1-year follow-up confirmed the safety of the technique, showing aneurysm shrinkage, absence of any endoleak, and patent visceral vessels