Endovascular repair of abdominal aortic aneurysm with pelvic transplant kidney with antegrade deployment of iliac limb

A 63-year-old woman presented with a symptomatic aneurysm and a pelvic transplant kidney on the side of an external iliac artery occlusion. A commercially available bifurcated endograft was introduced through the common iliac artery contralateral to the kidney. The external iliac artery occlusion required antegrade delivery of an iliac limb through the contralateral endograft gate and cannulation of the common iliac artery to allow for deployment proximal to the transplant kidney artery. This technique was successful and remains so six months postoperatively. Endovascular repair of aneurysms proximal to pelvic transplant kidneys remains the preferred method of repair. However, inadequate access vessels may require antegrade delivery of endograft components which is facilitated by advances in endograft design.