Fig. 1

Images of a 77-year-old man who underwent EVAR for the treatment of an AAA with a hostile neck anatomy (aortic neck length, 7 mm). a Three-dimensional reconstruction of CTA demonstrating the short neck length of the aneurysm. b A 5 F catheter (arrowhead) was inserted into the left renal artery via brachial artery access to avoid unintentionally covering the left renal artery. c A 0.035-inch wire was preloaded into the sac (black arrow), and after endograft implantation and balloon moulding, angiography revealed a type Ia endoleak (white arrow). d A 5 F catheter (black arrow) was inserted via the preloaded wire into the sac neck, and saccography confirmed the catheter's position (white arrow). e The coils (white arrow) were delivered via a catheter to the site of the sac neck, and the final angiography confirmed resolution of the endoleak