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A 77 year-old-man presented with right leg pain. The enhanced CT scan showed a right deep femoral artery aneurysm measuring 35 mm and necrosis of the femoral muscle. We conclude the necrosis was caused by embolism. We performed arterial reconstruction with ePTFE graft between the common femoral artery to the superficial femoral artery and deep femoral artery. The postoperative course was uneventful.

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Endovascular aneurysm repair EVAR of pararenal abdominal aortic aneurysm pararenal AAA includes fenestrated or branched endografts, and the chimney technique. However, fenestrated and branched endografts are not currently available. An 82-year-old man, who underwent EVAR two years previously, was admitted to our hospital because of pararenal AAA measuring 56 mm. He underwent endovascular treatment with the chimney technique for bilateral renal arteries. We used a selfexpanding and balloon-expandable uncovered-stent in renal arteries. Postoperatively he had slight renal dysfunction and acute pancreatitis, but was discharged 14 days after surgery. EVAR with the chimney technique for bilateral renal arteries was thought to be useful in high risk patients with pararenal AAA. Jpn. J. Cardiovasc. Surg. 44 : 256 260 2015 pararenal abdominal aortic aneurysm ; chimney method ; endovascular surgery ; stent-graft