Methods: Between March 2013 and March 2014, four consecutive patients (3 males, 1 female; mean age 66.8 years; range 63 to 73 years) with type-V thoracoabdominal aortic aneurysms underwent endovascular aortic repair with parallel grafts. Chimney and sandwich grafts were inserted from an axillobrachial access, while periscope grafts and aortic endografts were delivered via transfemoral access.

Results: The mean follow-up was 16.25 (range 9 to 22) months. All aortic stent-grafts and parallel grafts were implanted with 100% procedural success. The aortic aneurysms were excluded with thoracic endografts (n=11) and a bifurcated stent-graft. A total of 16 parallel grafts (8 sandwich grafts, 2 chimney grafts, and 6 periscope grafts) using 26 Viabahn®- coated stents were placed to maintain blood flow to eight renal and eight visceral arteries. Temporary worsening of kidney function was seen in a patient. During follow-up, three of the four patients were uneventful and a subdural hematoma developed in a patient in the first postoperative month. No postoperative mortality was seen in any patient. No aneurysmal growth was seen. All parallel grafts were patent. Minimal type-I and type-III endoleaks were observed in two patients with short-term follow-up.

Conclusion: The parallel graft technique to treat type-V thoracoabdominal aortic aneurysms is a feasible and less invasive alternative method with extremely low mortality rates.