Abstract
A 75-year-old male with history of uncontrolled hypertesion and triple A 2 years ago, admitted to our hospital with a complaint of 2-day abdominal pain. Multislice computed tomography (MSCT) showed big abdominal aortic aneurysm (61 mm in diameter). He was found to have a shortness and angulation of proximal landing-zone, which is very important to perform endovascular aortic repair (EVAR) safely. He achieved medical management to control hypertension and pain. EVAR technique was perform with careful planning of fenestrated left renal artery. The operation was performed as the plan, the aneurysm was eliminated, the AAA was covered by stent-graft and the left renal artery stent was placed precisely without endoleak. He was discharged after 5 days without complications. It was very important to measure the size of the aortic lesion, especially character of aneurysmal neck. Placing precise position of the fenestrated hole to the ostium of the left renal artery and deploying the stent-graft were very important to have a good result in emergency procedures.