Figure 5a. Enlarging abdominal aortic and bilateral iliac artery aneurysms. (a) Anterior view of a three-dimensional shaded-surface display of a pretreatment contrast agent-enhanced CT scan delineates the aneurysms (arrowheads). (b) Posteroanterior aortogram obtained after placement of a bifurcated endograft (Excluder; W. L. Gore & Associates, Flagstaff, Ariz) and embolization of the left iliac artery with Gianturco coils (Cook, Bloomington, Ind). Arrows delineate upper (aortic) end and lower (iliac) ends of the endograft. Note that there is no flow seen outside of the endograft within the aortic aneurysm (ie, no endoleak), the upper end of the graft is well positioned in the upper aortic "neck" just below the renal arteries, and the embolization coils in the left internal iliac artery trunk are seen just below and medial to the left distal endograft attachment. Although the right internal iliac artery is patent and provides flow across the pelvis (depicted on later arteriographic frames, not shown), the coils prevent retrograde filling of aneurysms.