title: Hybrid Treatment of a Suprarenal Aortic Aneurysm with an Infrarenal Aortobifemoral Surgical Graft and a Fenestrated Stent Graft.
abstract: BACKGROUND
  The aim of this study was to report a hybrid technique for the treatment of a suprarenal aortic aneurysm (SAA) in a patient with iliac occlusive disease. Initially, an infrarenal aortobifemoral surgical graft was implanted, followed by deployment of a fenestrated bifurcated stent graft at the suprarenal part of the aorta.
  
  
  METHODS
  A 69-year-old man presented with a 51-mm saccular suprarenal aortic aneurysm and iliac occlusive disease with intermittent claudication. Both common iliac arteries had been previously treated with kissing stents. Both external iliac arteries were severely stenosed precluding a total endovascular approach.
  
  
  RESULTS
  The patient was treated with an infrarenal aortobifemoral surgical graft, facilitating the implantation of a custom-made fenestrated stent graft with fenestrations for the renal arteries and the superior mesenteric artery and a scallop for the celiac artery. The procedure was uneventful. Postoperative computed tomography angiography confirmed complete exclusion of the aneurysm and patent target vessels. Postoperatively, the patient did not report claudication symptoms anymore.
  
  
  CONCLUSIONS
  A hybrid approach is a viable alternative to treat patients with complex aortic aneurysms and simultaneous peripheral occlusive disease, otherwise excluded from fenestrated stent grafting due to unsuitable access vessels.
authors.affiliation: Department of Vascular and Endovascular Surgery, Paracelsus Medical University, Nuremberg, Germany.
authors.forename: Sebastian
authors.initials: S
authors.lastname: Nagel
authors.affiliation: Department of Vascular and Endovascular Surgery, Paracelsus Medical University, Nuremberg, Germany. Electronic address: akatsargyris@gmail.com.
authors.forename: Athanasios
authors.initials: A
authors.lastname: Katsargyris
authors.affiliation: Department of Vascular and Endovascular Surgery, Paracelsus Medical University, Nuremberg, Germany.
authors.forename: Kyriakos
authors.initials: K
authors.lastname: Oikonomou
authors.affiliation: Department of Vascular and Endovascular Surgery, Paracelsus Medical University, Nuremberg, Germany.
authors.forename: Eric L G
authors.initials: EL
authors.lastname: Verhoeven
mesh_terms: D000368:Aged; D017544:Aortic Aneurysm, Abdominal / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*; D001027:Aortography / Q000379:methods; D001157:Arterial Occlusive Diseases / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*; D001807:Blood Vessel Prosthesis; D019917:Blood Vessel Prosthesis Implantation / Q000295:instrumentation*; D000072226:Computed Tomography Angiography; D003251:Constriction, Pathologic; D057510:Endovascular Procedures / Q000295:instrumentation*; D006801:Humans; D007083:Iliac Artery / Q000000981:diagnostic imaging; D007383:Intermittent Claudication / Q000209:etiology; D008297:Male; D011474:Prosthesis Design; D015607:Stents; D016896:Treatment Outcome