Endovascular repair of abdominal aortic aneurysm using a pararenal fenestrated stent-graft.
OBJECTIVE
To report an unusual case of endovascular abdominal aortic aneurysm (AAA) exclusion in which a fenestrated stent-graft was used to seal a proximal Type I endoleak.


RESULTS
An 84-year-old man with a 6.0-cm AAA underwent an aortomonoiliac aneurysm exclusion procedure that was complicated by a proximal endoleak. Because the patient had no right kidney, an additional stent-graft was designed to cover the right renal artery stump while preserving left renal perfusion through a fenestration in the graft material. This approach was successful in obliterating the endoleak around the proximal attachment site, but flow through the lumbar arteries remained.


CONCLUSIONS
The use of a fenestrated stent-graft is feasible, but the type of fenestration in this case has limited applicability owing to the rarity of patients with suitable anatomy.
Faruqi
R M
RM
Division of Vascular Surgery, University of California San Francisco 94143, USA.
Chuter
T A
TA
Reilly
L M
LM
Sawhney
R
R
Wall
S
S
Canto
C
C
Messina
L M
LM
D000368:Aged; D000369:Aged, 80 and over; D000714:Anastomosis, Surgical; D017544:Aortic Aneurysm, Abdominal / Q000000981:diagnostic imaging / Q000601:surgery*; D001027:Aortography; D001807:Blood Vessel Prosthesis; D019917:Blood Vessel Prosthesis Implantation / Q000295:instrumentation*; D005263:Femoral Artery / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D017543:Iliac Aneurysm / Q000000981:diagnostic imaging / Q000601:surgery; D007083:Iliac Artery / Q000000981:diagnostic imaging / Q000601:surgery*; D008297:Male; D011474:Prosthesis Design; D015607:Stents; D014057:Tomography, X-Ray Computed