Hybrid Approach to Achieve Secure Distal Seal Zones during Endovascular Aortic Repair in a patient with Marfan Syndrome

This report details a hybrid approach for treatment of abdominal aortic aneurysm in a patient with Marfan syndrome. A 34-year-old patient with Marfan syndrome and prior open thoracoabdominal aortic aneurysm repair underwent bilateral common iliac artery interposition graft repair and endovascular aortic repair. The bifurcated stent graft was implanted into the previous thoracoabdominal graft proximally and iliac interposition grafts distally. Postoperatively, the patient recovered uneventfully with sac regression to 4.5cm through 2-year follow-up, without seal zone degeneration. This hybrid approach aimed to eliminate landing zone degeneration in Marfan syndrome patients undergoing endovascular repair.