RESUMEN
In last 30 years, the endovascular aneurysm repair (EVAR) has become the standard method of treatment of abdominal aortic aneurysms (AAAs). Nevertheless, the method has limitations mainly based on the anatomic characteristics of the specific aneurysm. In these cases, a combination of endovascular and open techniques can be used. We describe a case of a patient with an infrarenal AAA and an ectopic right renal artery emerging from within the aneurysm sac. The patient was treated with a combination of endovascular and open techniques. In particular, he underwent a hepatorenal revascularization followed by a standard EVAR procedure, with a successful final outcome. For the treatment of AAA disease, the combination of open and endovascular procedures can overcome difficulties, where a standard EVAR cannot be an option.