Off the Shelf Branched Endovascular Aortic Repair of a Thoraco-Abdominal Aneurysm with a Solitary Kidney with Two Arteries.

A 68 year old female was admitted with an asymptomatic 62 mm type III thoraco-abdominal aortic aneurysm complicated by a solitary kidney with two arteries. An off the shelf device (Zenith t-Branch, Cook, Bloomington, IN, USA) was deployed slightly rotated to the left to facilitate cannulation of the accessory left renal artery via the right renal portal of the branched device (A, B asterisk). Bridging stents (Begraft+, Bentley Innomed, Hechingen, Germany) were deployed via a transfemoral steerable guide (Aptus, Medtronic, Dublin, Ireland) (A, arrows). Follow up imaging at 30 days showed patent branches and complete exclusion of the aneurysm sac.