Double endovascular repair in a patient with Marfan syndrome and postdissection thoracoabdominal aortic aneurysm: Twelve years of follow-up.

A patient with Marfan syndrome and prior open aortic surgery presented with a chronic post-type B dissection thoracoabdominal aneurysm measuring 6.5 cm in diameter. He underwent successful endovascular repair using a surgeon-modified fenestrated endograft. During follow-up, he developed infectious aortitis and permanently lost right kidney function. Multiple endovascular reinterventions were performed, including complete relining with a T-branch endograft to address graft degeneration. After 12 years, the aneurysm sac remained stable at 6.3 cm; renal function stabilized without dialysis, and he continued prolonged antibiotic therapy. This case demonstrates the technical feasibility and long-term durability of sequential endovascular repair in Marfan-associated aortic disease under multidisciplinary management.