Figure 2. Large complex abdominal aortic aneurysm (AAA) in an elderly patient with severe chronic obstructive pulmonary disease. (A) Intraoperative angiogram reveals complex aneurysm with 1) angulated proximal neck; 2) 7.5-cm AAA; 3) 9-cm right common iliac artery aneurysm; 4) 3-cm left common iliac artery aneurysm; 5) severely tortuous access vessels; and 6) left femoral aneurysm (F). (B) Successful endovascular graft repair was performed with the Montefiore endovascular graft. Note the absence of endoleaks as well as lack of visualization of all the aneurysms.