2023 Volume 32 Issue 4 Pages 295-299
The patient was a 72-year-old man. He admitted to the hospital with a chief complaint of abdominal pain, and a CT scan revealed abdominal aortic and iliac artery aneurysms. He had a horseshoe kidney with the inferior pole branch of the left renal artery whose orifice was located 76 mm proximally from the terminal aorta. The iliac artery aneurysm was 35 mm in diameter and there were comorbid risks including a history of cerebral hemorrhage; therefore, we performed endovascular aneurysm repair. We initially considered AFX as the device of choice for short distances from terminal aorta; however, there seemed to be a risk of covering the branch orifice by the AFX fabric due to the severe aortic angulation. We finally selected Gore Excluder C3 whose proximal stent can be squeezed after partial deployment for “repositioning”. We inserted the balloon and dilated in the contralateral gate and carefully pulled whole device downward and repositioned it. After the operation, there were no endoleaks, the pole renal branch was patent, and the renal function did not deteriorate.
