CardioVascular and Interventional Radiology

, Volume 42, Issue 3, pp 455–459 | Cite as

Double-Barreled and Branched Endografting for Thoracoabdominal Aortic Aneurysm: The Hexapus Technique

  • Hsu-Ting Yen
  • Chun-Che Shih
  • I-Ming ChenEmail author
Technical Note



To treat thoracoabdominal aortic aneurysm (TAAA), we introduced an alternative “Hexapus” technique by double-barreled and branched endografting.

Technique and Result

We established 2 transfemoral and 2 transaxillary access routes first and then deployed two abdominal bifurcated stentgrafts landing at the descending thoracic aorta through transfemoral routes, respectively. Two pairs of parallel stentgrafts were deployed via bilateral transaxillary route from each of contralateral limbs of main body stentgrafts to visceral arteries. Finally, we extended the ipsilateral limbs of main body stentgrafts to bilateral common iliac arteries as distal landings. The creation of six branches (four viscerals and two iliacs) resembles a hexapus. We have executed this Hexapus technique in three patients, and the final angiography during operation and postoperative 12-month image follow-up showed patent visceral branches and no any endoleaks.


Our Hexapus technique is feasible in treating TAAA if patient is inoperable or no commercial fenestrated or branched stentgraft is available.


Thoracoabdominal aortic aneurysm Endovascular aortic repair Stentgraft Double-barreled Hexapus 



Special thanks to the Taiwan Association of Cardiovascular Surgery.

Compliance with Ethical Standards

Conflict of interest

The authors declare no conflicts of interest.


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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature and the Cardiovascular and Interventional Radiological Society of Europe (CIRSE) 2018

Authors and Affiliations

  1. 1.Division of Cardiothoracic Surgery, Department of SurgeryChung Gung Memorial HospitalKaohsiungTaiwan
  2. 2.Division of Cardiovascular Surgery, Department of SurgeryTaipei Veterans General HospitalTaipeiTaiwan
  3. 3.Institute of Clinical Medicine, School of MedicineNational Yang Ming UniversityTaipeiTaiwan
  4. 4.Department of Medicine, School of MedicineNational Yang Ming UniversityTaipeiTaiwan

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