Hybrid repair of subclavian-axillary artery aneurysms and aortic arch aneurysm in a patient with marfan syndrome

A patient with Marfan syndrome who had previously undergone a Cabrol procedure and thoracoabdominal aortic replacement had enlarging, symptomatic aneurysms in the subclavian-axillary artery and aortic arch. Both vessels were replaced with prosthetic grafts. A thoracic endoprosthesis was inserted bridging the aortic arch graft and the previously implanted descending aorta graft. Another stent graft was placed, bridging the axillary artery and a branch of the aortic arch graft. All the stent graft landing zones were within grafts, avoiding contact between the endoprostheses and fragile aortic wall. The aneurysms were excluded from the circulation, and the patient had no serious complications.