Fig. 1

Creation of inverted iliac limb using the Cook Zenith Fenestrated distal bifurcated body stent graft. a Preparing the inverted limb. Note that the graft is partially deployed; the contralateral limb transected using an ophthalmologic cautery. The check mark is placed in the original orientation to facilitate gate cannulation. b Minimum distance to the flow divider post limb inversion. The length from the top of the stent graft to the gate has been reduced from 76 mm to 51 mm, allowing relining of the entire failed previous EVAR. c Securing the inverted limb to the bifurcated device. The transected limb is now inverted and sewn in place with a 5–0 double arm ethibond suture