Abdominal aortic aneurysms (AAA) and thoracic aortic aneurysms (TAA) are localized dilations of the abdominal aorta and thoracic aorta respectively. They are the thirteenth leading cause of death in the United States [1, 2]. Endovascular aneurysm repair (EVAR) has become a routine approach to treat aortic aneurysms. At the same time, an in situ fenestration technique is used to treat complex aortic aneurysms when the aneurysm involves vital adjoining arteries such as the renal arteries or left

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... ubclavian artery, and deployment of a conventional stent-graft would block blood flow to the kidneys or the left arm [3,4].