Bilateral renal in situ reimplantation enabling endovascular repair of a complex aortoabdominal aneurysm: a challenging surgical case report

We present the case of a 58-year-old male with a complex suprarenal and infrarenal aortoabdominal aneurysm and multiple renal arteries. Due to anatomical constraints that precluded endovascular repair, bilateral renal in situ reimplantation was performed, followed by the successful deployment of a physician-modified endograft. Despite postoperative complications, the patient recovered fully and was discharged in stable condition. This case highlights the feasibility and clinical value of combining open and endovascular techniques in high-risk vascular patients when standard endovascular approaches are not viable.