Extensiveaneurysmsinvolvingtheascendingaorta,aorticarch,andthedescendingaortastandasatherapeuticdilemmainsimultaneousmanagementofmultiplesitesofpathologyoftheaorticarchandthedescendingthoracicaorta.Wesystematicallyreviewedaboutliteraturesofstentedelephanttrunkoperation(SET)identifiedthroughsearchesoftheelectronicdatabasesEMBASEandMedline,andaimedtosummarizestudiesofpatientsundergoingSETforextensiveaneurysms.Since1996,KatoMintroducedahybridtechniquebyusingstentedgraftimplantationtothedescendingaortafortreatmentofthoracicaorticaneurysmordissection.Ithasbeendescribeagoodoptionforextensivethoracicaorticaneurysmsandinafashionsimilartotheelephanttrunktechnique.