Endovascular repair of abdominal aortic aneurysm using a pararenal fenestrated stent-graft

Purpose: To report an unusual case of endovascular abdominal aortic aneurys m (AAA) exclusion in which a fenestrated stent-graft was used to seal a pro ximal Type I endoleak. Methods and Results: An 84-year-old man with a 6.0-cm AAA underwent an aort omonoiliac aneurysm exclusion procedure that was complicated by a proximal endoleak. Because the patient had no right kidney, an additional stent-graf t 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.