Double endovascular repair in a patient with Marfan syndrome and post-dissection thoracoabdominal aortic aneurysm: 12 years of follow-up

A patient with Marfan syndrome and prior open aortic surgery presented with a chronic post Type B dissection thoracoabdominal aneurysm measuring 6.5 cm in diameter.He underwent successful endovascular repair using a surgeon-modified fenestrated endograft.During followup, he developed infectious aortitis and permanently lost the right kidney function.Multiple endovascular reinterventions were performed, including complete relining with a T-Branch endograft to address graft degeneration.After twelve years, the aneurysm sac remained stable at 6.3 cm; renal function stabilized without dialysis, and he continued prolonged antibiotic therapy.This case showed technical feasibility and long-term durability of sequential endovascular repair in Marfan-associated aortic disease under multidisciplinary management.