Duprey Ambroise, Ben Ahmed Sabrina, Millon Antoine, Feugier Patrick, Favre Jean-Pierre, Albertini Jean-Noël
Department of Cardiovascular Surgery, University Hospital of Saint-Etienne, Saint-Etienne, France.
Department of Vascular Surgery, University Hospital of Clermont-Ferrand, Clermont-Ferrand, France.
Ann Vasc Surg. 2017 Aug;43:317.e5-317.e11. doi: 10.1016/j.avsg.2017.04.043. Epub 2017 May 8.
An 81-year-old woman was referred for the treatment of a 79-mm-diameter short neck abdominal aortic aneurysm with highly tortuous iliac arteries. She was considered at high risk for open repair and not suitable for standard endovascular repair given the short length of the proximal neck. Delay for a manufactured custom-made fenestrated stent graft was too long given the diameter of the aneurysm. A flexible stent graft was preferred because of severe iliac tortuosity. Endovascular repair was performed using a physician-modified Anaconda stent graft with 1 fenestration for the left renal artery. The technique for device modification and implantation is described. Postoperative course was uneventful and 1-year computed tomography scan showed complete exclusion of the aneurysm sac and patent left renal artery.
