Abstract
Identification of the Adamkiewicz's artery (AKA) prior to the operation is one of the spinal cord ischaemia preventive measures. A 75-year-old man presented with the rapid expansion of thoracic aortic aneurysm. Collateral vessels from the right common femoral artery to the AKA were observed on preoperative computed tomography angiography. The stent graft was successfully deployed through the contralateral side via a pararectal laparotomy to avoid collateral vessel injury supplying the AKA. This case highlights the significance of preoperative identification of collateral vessels to the AKA.