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Fenestrated endovascular aneurysm repair (FEVAR) is an option for management ofa very complex abdominal aortic aneurysm (AAA). We are reporting on the case of a74-year-old male with a 7.8 × 6.8 cm juxtarenal abdominal aortic aneurysm that arises atthe level of the renal arteries and extends down to just above the iliac bifurcation andsevere bilateral renal artery stenosis with caudally oriented left renal and cranially orientedright renal artery. This case shows that a strategy with fenestrated graft is feasible foraortic aneurysm repair and may offer a reasonable option for patients with very complexaortic anatomy. The patient was discharged home in 4 days without complications. Thecomputed tomography angiography at 1 month showed a small type II endoleak at aorticbifurcation level. The patient remained well on follow up 4 months post-surgery.
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