Figure 1 

A 92-year-old woman presented to the emergency department with a symptomatic 65cm infra-renal abdominal aortic aneurysm. The computed tomography angiogram showed a severely angulated infra-renal aortic neck and highly tortuous iliac arteries (Panel A), which were out of the instructions for use of standard aortic endografts. Due to her age, open repair was not considered. However, since she was independent and otherwise fit, an EVAR was offered and performed under local anesthesia and through bilateral percutaneous femoral access. Due to the severe angulations, we decided to use the Gore® Excluder® Conformable AAA endoprosthesis. The main body and iliac limbs were advanced over a Terumo® Glidewire Advantage® 0.035’’ guidewire and deployed over the floppy 30cm tip to allow for adequate conformability to the different angulations. As shown in Panel B and C, the aneurysm was excluded with perfect conformability to the patient’s anatomy, illustrating the advantages of the conformable device.(Figure 1)