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 the lumina of the visceral and renal arteries and cause chronic mesenteric, renal, and lower limb ischemia. We report a case of chronic mesenteric and limb-threatening 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 a 3-year primary patency rate of 100%. We believe our case supports consideration of endovascular treatment for symptomatic CRA-related lesions, especially those diagnosed after remote open aortic surgery.