The endoluminal approach of the diffusely atheromatous aorta (DAA) is an emerging tool to prevent further embolization. We treated one symptomatic patient with DAA. We designed a catheter with a balloon at the tip for occlusion of both common iliac arteries through which the antegrade flow was allowed by an iliac to femoral arterio-arterial shunt connected to an in-line filter. Filter wires were also placed in the superior mesenteric and both renal arteries' take-off, keeping their antegrade flow. The endograft was then introduced through these tubes. Endoluminal treatment of the primary source of atheromatous embolization is feasible, representing a new approach to be considered.
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