Thoracoabdominal aortic aneurysms (TAAAs) are generally asymptomatic and are discovered incidentally on chest imaging. When they become symptomatic, these aneurysms manifest as abdominal pain related to ischemia of branches of the aorta. When they are identified, management is often expectant, depending on the size of the aneurysm and its rate of growth. Surgery is indicated for larger aneurysms and those that expand rapidly so as to avoid catastrophic rupture of the aneurysm. Here, we present the case of a 70-year-old woman with a TAAA whom we had been following with serial computed tomographic angiography scans. The decision to operate was made when the aneurysm began revealing growth in diameter. Her anatomy was not conducive to endovascular treatment; therefore, we repaired her aneurysm using a traditional open approach.
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