A 94-year-old woman with rupture of a thoracic aortic aneurysm (rTAA) was referred to us. She previously underwent thoracic endovascular aortic repair and was considered to be at high risk for a conventional open operation. Therefore an endovascular procedure was planned. The proximal landing zone needed to be placed at the ascending aorta to seal a type 1a endoleak. A hybrid operation consisting of supraaortic total debranching on the common femoral artery and endovascular repair was performed. All debranched bypasses were patent and the aneurysm was excluded. The patient regained sufficient ambulatory strength and showed no symptoms of syncope.
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