Antegrade thoracic endovascular aortic repair via the left axillary artery in a patient with aortoiliac occlusive disease (Leriche syndrome)

We present the case of a 77-year-old man with a saccular descending thoracic aortic aneurysm who underwent successful antegrade thoracic endovascular aortic repair (TEVAR) via the left axillary artery. The patient had a history of axillo-bifemoral bypass grafting due to aortoiliac occlusive disease (Leriche syndrome), which precluded normal retrograde TEVAR. Upon successful procedure completion, no endoleak was noted on postoperative computed tomography. The patient was discharged from the hospital without any complications. The left axillary artery is useful as an alternative access site in cases wherein conventional retrograde TEVAR is not feasible.