共存的多级主动脉病变是由动脉粥样硬化和高血压引起的，并在一小部分患者中出现。血管内修复术是一种安全有效的治疗方法。然而,针对两个主动脉段同时使用胸血管内修复术(TEVAR)和血管内动脉瘤修复术(EVAR)的小系列和病例报告较少.确定同时和单独TEVAR和EVAR治疗多水平主动脉病变的结果。2010年至2020年间，31例患者和22例患者接受了一期和二期修复治疗，分别在一个中心。所有患者均伴有胸主动脉和腹主动脉疾病（主动脉夹层，动脉瘤,和穿透性主动脉溃疡）。与两级主动脉修复术患者相比，一期修复患者年龄较大(平均年龄，68vs.57岁；P<0.001），并且具有更大的术前最大主动脉直径（67.03±10.65vs.57.45±10.36mm;p=0.002)。术中和术后结果显示，两阶段组的手术时间和住院时间（LOS）更长。两组术后并发症无明显差别。在后续行动中,一期组的再干预自由和平均生存率为100vs.100%,92.4vs.95%,和88vs.88%在一个，两个,5年,分别,而两阶段组的平均生存率为86.4。90.5%,87vs.90.5%,和76vs.84%的人，两个,5年,分别,均无统计学差异。TEVAR和EVAR联合可以成功进行，发病率和死亡率最低。一期修复与多级主动脉病变治疗的风险增加无关。
Coexisting multilevel aortic pathologies were caused by atherosclerosis and hypertension and presented in a small subgroup of patients. Endovascular repair is a safe and effective treatment for a variety of aortic pathologies. However, fewer small series and cases were reported using simultaneous thoracic endovascular repair (TEVAR) and endovascular aneurysm repair (EVAR) for both aortic segments. To determine the outcomes of simultaneous and separately TEVAR and EVAR treating for multilevel aortic pathologies. Between 2010 and 2020, 31 patients and 22 patients were treated by one-staged and two-staged repair, respectively at a single center. All patients had the concomitant thoracic and abdominal aortic disease (aortic dissection, aneurysms, and penetrating aortic ulcers). Compared with the patients with two-staged aortic repair, the one-staged repair patients were older (mean age, 68 vs. 57 years; P < 0.001) and had a larger preoperative maximal aortic diameter (67.03 ± 10.65 vs. 57.45 ± 10.36 mm; p = 0.002). The intraoperative and postoperative outcomes show that the procedure times and length of hospital stay (LOS) were longer in the two-staged group. There is no significant difference in postoperative complications between the two groups. In the follow up, the freedom from re-intervention and the mean survival rate for the one-staged group were 100 vs. 100%, 92.4 vs. 95%, and 88 vs. 88% at one, two, and 5 years, respectively, whereas the mean survival rate for the two-staged group was 86.4 vs. 90.5%, 87 vs. 90.5%, and 76 vs. 84% at one, two, and 5 years, respectively, all with no statistical difference. Combined TEVAR and EVAR can be performed successfully with minimal morbidity and mortality. The one-staged repair was not associated with the increased risk for multilevel aortic pathologies treatment.
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