[Total Aortic Arch Replacement for TypeⅠEndoleak after Thoracic Endovascular Aortic Repair using the Chimney Graft Technique:Report of a Case].

Here we report a case of total aortic arch replacement for typeⅠendoleak after thoracic endovascular aortic repair( TEVAR) using the concomitant chimney graft technique. An 81-year-old man was admitted with sudden back pain. Six years prior, he had undergone TEVAR for treatment of a distal aortic arch aneurysm. Preoperative computed tomography revealed an 80-mm-diameter arch aneurysm and typeⅠendoleak. The back pain was caused by impending aneurysmal rupture;therefore, urgent total arch replacement was performed. One stent was cut from the main endograft and anastomosed to its distal side. The bare metal stent in the left common carotid artery was removed and reconstructed at a healthy distal artery. Postoperative computed tomography revealed no endoleak of the aneurysm, and the patient's postoperative course was uneventful.