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CTA. (a) Infrarenal abdominal aortic aneurysm (AAA) with a diameter of 71.8 mm and suprarenal diameter aorta of 33.0 mm, (b) axial, and (c) coronal view showing the great stenosis of the left renal artery and the infrarenal aneurysm with an enlarged aortic neck diameter.
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Tomography Angiography (CTA) scan revealed greater stenosis of the left renal artery and a 72 mm infrarenal AAA with an enlarged aortic neck diameter (Figure 1) ; the suprarenal aorta measured 33.0 mm, while the infrarenal aorta was 31.9 mm just below the renal arteries with an enlargement of aortic neck to 37.4 mm.
3D computed tomographic reconstruction of an infrarenal abdominal aortic aneurysm. (a) Maximum diameter of the aneurysm, (b) P2: infrarenal aortic neck diameter, and (c) P3: distal diameter aortic neck.
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The sizing before EVAR was performed using EndoSize Case Planning Software:Version 3.1.47 (EndoSize  is registered trademarks of Therenva SAS) (Figure 2) .
Endovascular aneurysm repair. (a) AFX2 endograft and (b) AFX2 endograft placement with a thoracic stent as a proximal cuff, normal renal perfusion:renal artery stent (arrows).
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The proximal sealing zone of the thoracic stent graft was the infrarenal aorta, while the two grafts had at least a 4 cm overlap to minimize the risk of a type III endoleak (TIIIEL; Figure 3).
Follow-up CTA after 1 month. (a, b) Three-dimensional reconstruction of an adequate aneurysm sealing with no sign of endoleak or migration, (c, d) coronal view demonstrating the combined AFX2 with a thoracic stent graft, and (a, c) patent left renal artery with a stent (blue arrow).
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Repeat CTA, 3 months postoperatively, showed no evidence of endoleak or migration and an adequate aneurysm sealing (Figure 4).