Abstract
Thoracic aortic aneurysms (TAAs) carry high mortality without intervention, and thoracic endovascular aortic repair (TEVAR) has become a preferred minimally invasive option for high-risk patients. We report a 90-year-old male with prostate cancer and type 2 diabetes, who presented with hemoptysis and left-sided chest pain, initially attributed to lobar pneumonia but later diagnosed as a 40 mm saccular descending TAA compressing the left lung on CT angiography. The patient underwent successful TEVAR with complete symptom resolution and was discharged within five days, demonstrating TEVAR's efficacy in fragile elderly patients. This case highlights TEVAR's advantages over open repair, including reduced morbidity and faster recovery, while underscoring the need for further research on long-term outcomes and anatomical limitations in complex cases to refine patient selection and expand applications.