Abstract

Thoracoabdominal aortic aneurysm (TAAA) is a complex vascular condition traditionally managed with open surgery, which carries a high procedural risk. Advances in endovascular techniques, particularly the use of multibranched endografts such as the T-branch stent graft, have offered a minimally invasive alternative for high-risk patients. However, procedure-related complications, including endoleaks and branch vessel injuries, continue to pose significant challenges.

We report the case of an 84-year-old woman with a history of type B aortic dissection who underwent T-branch endovascular repair for an abdominal aortic aneurysm. Due to unfavorable vascular anatomy, completion of the left renal artery bridging stent was not possible during the initial procedure. The following day, the patient developed hypovolemic shock caused by rupture of a left renal artery branch and a stent-related endoleak. Digital subtraction angiography identified the bleeding source, and combined endovascular embolization using coils and an Amplatzer vascular plug was performed, necessitating sacrifice of the left renal artery. Hemostasis was successfully achieved, and the patient's condition stabilized.

This case underscores the critical role of image-guided interventional therapy in the timely diagnosis and management of life-threatening complications following complex endovascular aortic repair. A combined embolization approach can effectively control endoleaks in multibranched stent systems, highlighting the im portance of interdisciplinary collaboration in contemporary vascular treatment.

DOI: doi.org/10.63721/26JCTC0128

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