[Staged Hybrid Repair with Branched Collared Graft for Extensive Thoracic Aortic Aneurysm and Shaggy Aorta:Report of a Case].

The patient, a 64-year-old woman, presented with chest and back pain. A computed tomography( CT) scan revealed extensive dilatation of the entire thoracic aorta, along with a shaggy lesion and significant mural thrombus. A two-stage hybrid surgical approach was undertaken. In the first stage, ascending and total arch aortic replacement was performed using a four-branched collared graft (Gelweave ET), along with the placement of a conventional elephant trunk( CET). The second stage, thoracic endovascular aortic repair( TEVAR), was successfully performed on postoperative day eight. No major postoperative complications were observed. This staged approach, combining total arch replacement with CET placement via median sternotomy followed by TEVAR, provided a less invasive and safer alternative, particularly in minimizing the risk of cerebral infarction.