Successful endovascular treatment of a symptomatic perivisceral/juxtarenal coral reef aortic lesion using balloon-expandable aortic, mesenteric, and renal parallel/snorkel stent grafts

Coral reef aorta (CRA) has been defined as calcified, often eccentric abdominal aortic plaques that frequently extend into lumina of visceral and renal arteries and cause chronic mesenteric, renal, and lower limb ischemia.We report a case of chronic mesenteric and limbthreatening ischemia secondary to a perivisceral and juxtarenal CRA lesion crossing the anastomosis of a remotely-constructed aortobifemoral graft.The patient was treated with balloon-expandable aortic, mesenteric, and renal parallel/snorkel stent grafts, which have exhibited 100% three-year primary patency.We believe our case supports consideration of endovascular treatment for symptomatic CRA-related lesions, especially those diagnosed after remote open aortic surgery.