Abstract
Giant abdominal aortic aneurysms (GAAAs) are extremely uncommon and carry a markedly increased risk of rupture. Their complex anatomy presents significant challenges for surgical management. Endovascular aneurysm repair (EVAR) has emerged as an increasingly utilized alternative in appropriately selected patients with favorable anatomy. We present the case of a 72-year-old male presenting with a non-ruptured, 12.8 cm infrarenal fusiform GAAA, successfully managed with elective EVAR using an Anaconda LoPro90 trimodular bifurcated endograft system (Terumo Aortic, Inchinnan, Scotland). We describe the clinical and radiologic features, technical approach, intraoperative challenges, and 10-month follow-up. EVAR using a bifurcated Anaconda endograft is a feasible and safe option for anatomically suitable GAAA patients, even in the presence of complex features such as angulated necks and iliac involvement. Further studies are warranted to establish long-term durability and optimal management protocols for GAAA.