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Descending thoracic aorta (DTA) inflow has been utilized as a secondary choice for restoring blood flow in cases of aortoiliac occlusive disease. This option is considered when graft failure, infection, or other intra-abdominal conditions contraindicates the use of the standard abdominal aortic approach. Additionally, when the abdominal aorta develops extensive and complicated circumferential calcified lesions, making it unsafe to clamp this segment, a DTA bypass can serve as a secure and effective alternative. It remains an important tool in the arsenal of vascular surgeons. The presence of coral reef aorta, a rare condition characterized by outwardly projecting calcified plaques on the juxtarenal and visceral aorta, poses a challenge in determining the best treatment approach, as it has yet to be defined.