Recently, an elderly patient with abdominal aortic aneurysm combined with thoracic aortic aneurysm who was referred from a tertiary hospital in the city was accurately diagnosed and successfully underwent complete endoluminal repair by our vascular surgery department, and the patient is now recovering well and was discharged on 2014-1-18. The patient’s condition was complicated by the insidious onset of the disease, the combination of two aortic aneurysms, previous pacemaker implantation and advanced age, and the risk and difficulty of the operation were extremely high. Mr. Huang, a 79-year-old retired worker in Guangzhou, was referred to our hospital from a tertiary hospital in Guangzhou for “recurrent vague abdominal pain for 2 years, recurring for 10 days”. “Two years ago, he started to have pain in his left side of the stomach, which was not very strong, and sometimes he vomited a little, but he did not have a fever. This time, the doctor there suggested that I come here to look at the blood vessels, and my family also wanted to investigate more clearly.” After coming to our department, the patient said this. After detailed medical history and physical examination, Director Lin Shaomang of our department instructed to perform CTA examination of the chest and abdomen; CTA showed that: 1: subrenal type abdominal aortic aneurysm combined with thoracic aortic aneurysm, abdominal aortic aneurysm diameter 4.3cm, thoracic aortic aneurysm diameter about 5cm, 1cm from the left subclavian artery; 2: abdominal aorta and bilateral iliac artery appendage thrombus, right common iliac artery and external iliac artery limited stenosis, the stenosis is less than Although aortic aneurysms are not true tumors, they are more dangerous than various malignant tumors. The risk of aortic aneurysm rupture is approximately 6.9:1 for men and women, and is highly correlated with the diameter and age of the aneurysm. Traditional open repair of aortic aneurysms is very risky, while endoluminal isolation repair requires consideration of the aneurysm anchorage area, access vessels, aneurysm angulation, and involved internal vessels, making it extremely difficult. Therefore, this disease is called an “untimely bomb” in the body. How to defuse the bomb The director of vascular surgery, Shaomang Lin, and the director of interventional medicine, Deji Chen, repeatedly read the CT films carefully, reviewed the previous experience of successful endoluminal repair for patients with complex aortic aneurysms and abdominal aortic aneurysms, carefully evaluated the patient’s surgical risks, and agreed that the patient should be given priority for minimally invasive endoluminal isolation repair and formulated an individualized and thorough surgical plan. The patient’s family was informed of the patient’s condition and the risks of surgery, and they expressed understanding and agreed to the surgical plan for endoluminal surgery. The patient was sent to the interventional unit on January 10, 2014, and under general anesthesia, Director Lin Shaomang and Director Chen Deji jointly performed endoluminal repair of abdominal aortic aneurysm + thoracic aortic aneurysm; the procedure showed irregular eccentric cystic dilatation in the arch of the aorta below 25px of the subclavian artery, good visualization of the willis loop, bilateral vertebral arteries are not dominant arteries, and the right renal artery below about The right common iliac artery and external iliac artery were limitedly stenosed with a diameter of only about 4.6 mm at the narrowest point, and the internal iliac arteries were locally dilated bilaterally. A self-expanding stent was released through the right femoral artery to overcome the stenosis of the right external iliac and common iliac arteries, and then the main stent of the thoracic descending aorta and the subclavian ball-expanding “chimney” stent were introduced and released, and then the main stent of the abdominal aorta was released through the right femoral artery. -The external iliac artery stent was then released through the right femoral artery. Thus, we successfully completed the endoluminal repair of this complex type of thoracic and abdominal aortic aneurysm. The patient recovered well after the operation, with no dizziness, abdominal pain, chest pain, normal diet and limb activities, and was discharged on the eighth postoperative day, January 18, 2014. The causes of aortic aneurysms are multiple, including degenerative changes such as atherosclerosis, inflammatory reactions, infections, trauma, and congenital abnormalities. Smoking, high blood pressure, high cholesterol, obesity, advanced age, and being male are all independent risk factors, and abstaining from smoking, eating a balanced diet, and exercising are good ways to prevent aortic aneurysms. Recent studies have suggested that taking beta-blockers and statins can protect the aneurysm and slow its growth. Finally, Director Lin Shaomang reminds us that aortic aneurysms often start insidiously, and the most common clinically is abdominal aortic aneurysm (subrenal type), which is often neglected, and early diagnosis is very important in view of the danger; common diagnostic imaging tests for aortic aneurysms include ultrasound and CTA; annual medical screening is recommended for people over 50 years old, especially men, smokers, hypertensives and people with a family history of abdominal aortic aneurysms. For national patients, generally speaking, surgical intervention is required for abdominal aorta over 5 cm, thoracic aortic aneurysm twice the diameter of normal contiguous aorta or eccentric in nature, or symptoms of pain and discomfort in the chest, abdomen, or back. In the event of sudden onset of severe pain in the chest, abdomen, or back, the patient should be admitted to the hospital immediately for emergency care; endoluminal repair is currently preferred, but the treatment strategy needs to be individualized and the preoperative evaluation must be comprehensive. Studies have shown that 12% of patients with abdominal aortic aneurysms also have thoracic aortic aneurysms. In patients with multiple aortic aneurysms such as the one in this case, not only is there a high rate of leakage of the second aneurysm, but also the risk of rupture, difficulty of surgery, postoperative complications such as ischemic paraplegia of the spinal cord, intracranial, visceral, and limb ischemia, stent endoleaks, and dislocation.