Clinical Images

Endovascular Repair of a Complex Thoraco- abdominal Aneurysm Covering the Descendent Thoracic and Abdominal Aortic Artery with a Four Fenestrated Stent Graft

Martin Rabellino, MD*, L. Garcia-Nielsen, MD§, M. Maynar, MD*

Martin Rabellino, MD*, L. Garcia-Nielsen, MD§, M. Maynar, MD*

A 74-year-old male patient with a thoracoabdominal aortic aneurysm diagnosis was admitted to our hospital. Multidetector computed tomography (MDCT) showed the extent of the aneurysm (Figure 1). A two-stage endovascular approach was planned to prevent paraplegia. In the first attempt, the thoracic prosthesis was placed up to 2 cm above the diaphragm. In the second procedure, a fenestrated prosthesis was placed, completely covering the abdominal aorta and common iliac arteries. Through its fenestrations, 4 covered stents were delivered, one for the celiac trunk, superior mesenteric artery and both renal arteries (Figure 2). No complications were observed. The MDCT images at 2 years revealed complete patency of the aortic fenestrated graft (Figure 3).


1. Bicknell CD, Cheshire NJ, Riga CV, et al. Treatment of complex aneurysmal disease with fenestrated and branched stent grafts. Eur J Vasc Endovasc Surg 2009;37:175–181.
From *the Department of Endovascular Therapy and §the Department of Interventional Cardiology, Hospiten Group, Santa Cruz de Tenerife, Spain. The authors report no financial relationships or conflicts of interest regarding the content herein. Manuscript submitted March 4, 2010 and accepted May 20, 2010. Address for correspondence: Martin Rabellino,­ MD, Department of Interventional Radiology, Hospiten Rambla, Rambla General Franco 115, 38001 Santa Cruz de Tenerife, Spain. E-mail: