Unique operative approach for dealing with a tortuous external iliac artery during abdominal aortic aneurysm endografting.

Endovascular repair of abdominal aortic aneurysms offers many benefits over open repair. However, there are many characteristics that can exclude patients from undergoing this minimally invasive procedure, such as iliac arterial pathology. The present report describes the case of an 85-year-old patient with an aneurysm in which the right external iliac artery presented a challenge for vascular access due to its severe tortuosity and hairpin turn. Access for endovascular repair was achieved via an end-to-end anastomosis of the external iliac artery through a transverse inguinal incision. This represents a new option for achieving endograft placement when confronted with vascular tortuosity.