Fenestrated endograft for recurrent paravisceral aortic pseudoaneurysm after thoracoabdominal aortic aneurysm open repair

Paravisceral aortic pseudoaneurysm is an uncommon late graft-related complication after thoracoabdominal aortic aneurysm open repair. The redo surgery and hybrid procedures are the treatments of choice, with significant perioperative morbidity and mortality rates. We report a total endovascular repair of a 56-mm paravisceral aortic pseudoaneurysm in a 65-year-old patient with a history of type V thoracoabdominal aortic aneurysm open repair and redo open procedure for a distal anastomotic pseudoaneurysm. The lesion was successfully treated with a custom-made four-fenestration endograft. At 18 months, the patient was asymptomatic without liver, renal, or pancreatic problems. Computed tomography angiography demonstrated the absence of endoleaks, the antegrade perfusion of visceral vessels, and the absence of stent graft fractures.