Total transfemoral repair of thoracoabdominal aortic aneurysm and aortic dissection.

We present the case of a 66-year-old man with chronic type A aortic dissection and paravisceral aneurysmal degeneration who underwent successful endovascular repair using the thoracoabdominal multibranch endoprosthesis. Owing to a prior carotid-subclavian bypass, we elected a total transfemoral approach to avoid upper extremity access. A transcatheter electrosurgical septotomy was performed to establish controlled communication between the true and false lumens, facilitating endograft delivery. All visceral branches were stented via dual-sheath telescoping technique. A completion angiography showed no endoleak. This case demonstrates the feasibility of total transfemoral thoracoabdominal multibranch endoprosthesis deployment in complex anatomy while preserving branch vessel perfusion.