Surgical strategy for advanced gastric cancer with a concomitant thoracoabdominal aortic aneurysm requiring arterial reconstruction of the visceral branches.

A 70-year-old man who presented with hematemesis was found to have advanced gastric cancer concomitant with a thoracoabdominal aortic aneurysm (TAAA), which involved all branches of the visceral arteries. The patient underwent the following staged operations: first, radical resection of the advanced gastric cancer with simultaneous reconstruction of the visceral branches, followed 1 month later by endovascular aortic replacement of the TAAA. He recovered uneventfully and was discharged without any paralytic complications or sign of graft infection.