Abstract
An 80-year-old Caucasian female with a symptomatic pararenal aortic aneurysm (AAA) presented with severe abdominal pain radiating to the back, which was associated with a significantly tender pulsating abdominal mass. The patient was deemed unfit for open repair, secondary to her significant multiple comorbidities. Her preoperative computed tomography (CT) angiography showed a 6 cm pararenal AAA with a short hostile neck; however, her aneurysm had a double-bubble sign, which we utilized as an adjunct for sealing zones. A 36-mm Cook Zenith device was deployed with complete exclusion of the AAA. The patient recovered uneventfully with complete resolution of her abdominal pain. On her 2-month follow-up CT angiography, there was no migration or endoleak, with a decrease in the aneurysm sac size. This case report highlights the benefit of having such an aortic configuration as an adjunct tool for proximal sealing zones and demonstrates that certain anatomy may be beneficial in selected patients.
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