Renal Fenestration Closure Technique in fenestrated endovascular repair for para-renal aortic aneurysm

To describe an endovascular technique to close a renal artery fenestration during fenestrated endograft implant for a para-renal aneurysm (p-AAA) without interfering with other visceral vessels REPORT: A 76-year-old-male with p-AAA underwent repair by a four fenestrations custom-made endograft. At the intra-procedural angiography, the right renal artery was occluded. In order to avoid a high-flow endoleak from fenestration, we performed the following technique: a 9F-steerable sheath was used to advance a 7F-sheath through the fenestration into aneurism. A balloon-expandable covered-stent was deployed across the fenestration and then occluded by two vascular plugs. At the completion angiography there was not endoleak from the right renal fenestration and at 6-month p-AAA remained completely excluded.