Surgical repair of thoracoabdominal aortic aneurysm accompanied by Leriche syndrome using a quadrifurcated graft without a distal anastomosis.

BACKGROUND The coexistence of Leriche syndrome and thoracoabdominal aortic aneurysm is rare and challenging for surgeons especially if there are no distal anastomosis sites. CASE REPORT A 56-year-old man with past medical histories of coronary artery bypass grafting and total arch replacement was planned to the surgery for thoracoabdominal aneurysm. His abdominal aorta was occluded just below the renal arteries and his terminal aorta, iliac and femoral arteries were hypoplastic. Right internal thoracic artery and visceral arteries provided collateral blood supply to the legs. The aneurysm was successfully repaired using a quadrifurcated graft without distal anastomoses. CONCLUSION A quadrifurcated graft can be a therapeutic option for repair of thoracoabdominal aneurysm accompanied by Leriche syndrome without distal anastomosis sites.