Endovascular repair of an abdominal aortic aneurysm associated with crossed fused renal ectopia

Chimney/snorkel endovascular aneurysm repair (Ch-EVAR) enables the minimally invasive treatment of abdominal aortic aneurysm in anatomically challenging and high-risk surgical cases. Here, we present the case of a 77-year-old man with an abdominal aortic aneurysm associated with crossed fused renal ectopia and an ectopic renal artery arising directly from the aneurysm sac. After successful implementation of Ch-EVAR, computed tomography angiography at 18 months revealed no endoleaks, patency of the parallel graft, and normal renal vascularization and function. This report underscores the feasibility of Ch-EVAR in a case with high anatomic complexity.