Retrograde in situ branched stent grafting for a patient with type V thoracoabdominal aortic aneurysm.

We have presented the case of a 76-year-old patient with a type V thoracoabdominal aortic aneurysm treated by retrograde in situ branched stent grafting to the superior mesenteric artery (SMA). Via a 9-cm, median laparotomy, a percutaneous transhepatic gallbladder drainage needle was inserted from the distal part of the first jejunal artery to the origin of the SMA. After stent graft placement into the aorta, the graft was retrogradely punctured using the percutaneous transhepatic gallbladder drainage needle. The SMA ischemic time was 6 minutes. The puncture site was dilated, and a small, covered stent was deployed. Postoperative computed tomography scanning showed no endoleak with sac regression.