Innovative endovascular stapling technique using the Aortoseal device in challenging infrarenal aortic neck

We report the use of the Aortoseal Endostapling system by Endoron in a 63-year-old man with infrarenal abdominal aortic aneurysm with high-risk neck features. Endovascular abdominal aneurysm repair was performed using a Medtronic Endurant IIs endograft with an adjunctive Aortoseal system as part of an international feasibility trial. The procedure was technically successful, with no endoleaks on completion angiography. Follow-up computed tomography angiography at 1 month confirmed a well-deployed AortoSeal system and complete aneurysm exclusion. This case highlights this innovative device and the technical considerations to enhance endograft proximal fixation with the potential to improve long-term outcomes in endovascular aneurysm repair.