Abstract
A 78-year old male was referred with an abdominal aortic aneurysm and a type 2 horseshoe kidney (HSK) perfused by an 8 mm renal isthmus artery (RIA) (A). Selective angiography confirmed the dependence of a large portion of the HSK on the RIA (blue arrow). Percutaneous fenestrated endovascular aneurysm repair was completed (Zenith fenestrated graft [ZFEN-P-2-32-94]; Cook Aortic Interventions, Bloomington, IN, USA) with a seal zone between the RIA and the renal arteries on each side. An iCAST stent (Atrium, Merrimack, NH, USA) (arrow) placed through the single fenestration preserved RIA perfusion. One-year follow-up showed a shrinking aneurysm sac and perfused HSK (B).Figure 1
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