Endovascular Completion of the Elephant Trunk in Type a Aortic Dissection: Case Report

The ascending and the arch of the aorta were replaced with an elephant trunk procedure in a 55-year-old male patient who had been operated for an acute type A aortic dissection one year ago. Here, we report the endovascular completion of the elephant trunk for treatment of the chronic dissecting aneurysm in the descending aorta. Despite a generous length of overlap betwe- en the elephant trunk and the endovascular stent-graft, a secondary intervention was necessary for type 1 endoleak from both ends, just one month later. The patient has been followed-up for 60 months, and has no problems. The secondary repair of the descending thoracic aorta in patients with previous arch replacement and elephant trunk extension can be done via endovascular route. Endovascular elephant trunk completion avoids a thoracotomy, and may improve morbidity and mortality in these high-risk patients.