An 89-year-old woman was followed with a diagnosis of thoracoabdominal aortic aneurysm (TAAA) with a diameter of 40 mm. Computed tomography (CT) scans revealed that the TAAA had rapidly expanded to 55 mm in diameter in just two years. She was admitted to our hospital. Considering her advanced age, conventional graft replacement was thought to be quite a high risk. Thus, we selected endovascular treatment. As the TAAA was located just above the celiac artery, it was necessary to deploy the stent-graft just proximal to the origin of the superior mesenteric artery in order to secure a sufficient distal landing zone. In this case, we could secure the maximum landing zone by using the endowedge technique with the staged deployment of the conformable TAG with ACTIVE CONTROL System. The postoperative course was uneventful, and CT disclosed complete occlusion of the aneurysm.

An 89-year-old man complained of pulsatile masses in his right groin. Computed tomography (CT) scans revealed an aneurysm of the right deep femoral artery. He was admitted to our hospital with a diagnosis of deep femoral artery aneurysm (DFAA). The clinical frailty scale score was 6 (moderately frail), and he also suffered chronic obstructive pulmonary disease (COPD). Considering his complicated frail and impaired pulmonary function, conventional graft replacement and aneurysmectomy were thought to be quite a high risk. Thus, we selected endovascular treatment. It was not possible to secure a sufficient proximal landing zone for measurement, we did not select a stent-graft treatment. Therefore, we performed hybrid therapy with proximal neck ligation and distal outflow coil embolization. The postoperative course was uneventful, and CT disclosed complete occlusion of the aneurysm.