(Disclaimer: This article is for scientific use only. Relevant information in the following content has been processed to protect patient privacy.) Abstract: This article describes an elderly woman who presented to the emergency room with 3 days of anterior chest occult pain. Emergency CTA examination revealed a giant aneurysm in the aortic arch with a maximum diameter of 5.3 cm and local intima with rupture, which was eligible for surgery. After the patient was admitted to the hospital, the surgical risk was evaluated and the surgical modality of minimally invasive treatment of aortic aneurysm, thoracic aortic aneurysm endoluminal isolation, was selected, and the patient’s chest pain disappeared after surgery. One month later, the patient had no obvious complaints of discomfort, and CTA showed that the patient’s aortic aneurysm was successfully isolated, making minimally invasive isolation treatment of aortic aneurysm a boon for elderly patients. Basic information】Female, 70 years old 【Disease type】Aortic aneurysm 【Visiting hospital】Liaoning Provincial People’s Hospital 【Visiting time】August 2021 【Treatment plan】Thoracic aortic aneurysm intracavitary isolation 【Treatment period】Inpatient treatment for 12 days, regular postoperative outpatient review for 1 month and 3 months 【Treatment result】The patient’s chest pain symptoms disappeared and the aneurysm was isolated successfully I. Initial interview In August 2021, a In August 2021, a 70-year-old female patient came to the emergency room with chest pain for 3 days. The patient had chest pain without obvious cause 3 days before, which was paroxysmal and vague and tolerable, and the pain relief was not obvious and progressively aggravated. The patient had no previous history of hypertension, diabetes, heart disease, cerebrovascular disease, and denied the history of smoking and alcohol. The patient had recently been able to eat and sleep, had normal bowel movements, and had not lost significant weight. After the patient was admitted to the hospital, the relevant examination was completed. Due to the patient’s sudden onset of chest pain, a consultation with relevant departments was requested, except for the possibility of acute pulmonary embolism and acute heart attack, and the cause of chest pain was clearly related to the aortic arch descending aortic giant aneurysm. After communicating with the family and the patient, the patient and his family were advised to use a minimally invasive technique to isolate the aortic aneurysm – aortic aneurysm endoluminal isolation – because of the good location of the aortic aneurysm and the aneurysm diameter is greater than 2 cm from the opening of the left subclavian artery. This is a minimally invasive interventional procedure that releases an overlying stent into the aortic aneurysm cavity to isolate the aortic aneurysm and reconstruct the blood flow in the aorta without an incision. The patient underwent endoluminal isolation of the thoracic aortic aneurysm under general anesthesia, and the procedure went well. The patient was discharged on the second day after surgery, and was observed for one week after surgery without discomfort. The patient’s postoperative chest pain disappeared and his blood pressure was well controlled. Regular outpatient review was performed one month and three months after surgery, and a full CTA examination of the aorta was performed: complete isolation of the aortic aneurysm was seen, no endoleaks were generated, there was no significant stenosis in the upper three branches of the aortic arch, blood flow was normal, the stent did not cover the left subclavian artery, the stent was in good shape, and there was no significant displacement. IV. Precautions I am glad that my patient obtained the ideal treatment result after surgical treatment, but the following matters need to be noted: 1. The most important follow-up of intracavitary isolation of aortic aneurysm is regular review of aortic CTA. Intracavitary treatment has the risk of endoleaks in the distant future and the risk of aneurysm recurrence with the passage of time, so patients need to be reviewed regularly to facilitate early detection of problems and timely treatment. 2. Blood pressure control is the most important precaution for aneurysm patients. Good blood pressure control can reduce both the risk of preoperative rupture and the probability of postoperative endoleaks; therefore, patients need to regulate blood pressure control. V. Personal insight Aortic aneurysm is a critical disease in vascular surgery and the most common aortic dilatation disease. Conservative treatment cannot hinder the progression of aortic aneurysm, and surgery is the only means of radical cure. However, traditional surgery is highly invasive and has many complications, which most patients cannot tolerate. Minimally invasive treatment of the aorta is indicated for patients with aneurysms below the aortic arch and is currently the treatment of choice for patients with aortic aneurysms, just like my patient whose outcome after surgical treatment was ideal. However, attention needs to be paid to the risk of aortic rupture once the aortic aneurysm develops symptoms such as pain in the chest and abdomen, and prompt treatment is required. In addition, if a patient presents with chest and back pain without a cause, the presence of aortic aneurysm should be noted in addition to consideration of acute heart attack and pulmonary embolism.