• Patient is ≥ 18 years of age

• Patients who are male or non-pregnant female (females of child bearing potential must have a negative pregnancy test prior to enrollment into the study)

• Patient or Legally Authorized Representative has signed an Institutional Review Board (IRB) approved Informed Consent Form

• Patient has a juxtarenal abdominal aortic aneurysm that meets at least one of the following:

∙ An aneurysm with a maximum diameter of ≥ 5.5 cm for male (≥ 5.0 cm for female) or 2 times the normal diameter just proximal to the aneurysm using orthogonal (i.e., perpendicular to the centerline) measurements

‣ Aneurysm with a history of growth \> 0.5 cm in 6 months

‣ Saccular aneurysm deemed at significant risk for rupture

‣ Symptomatic aneurysm

‣ Ruptured aneurysm

• Patient has patent iliac or femoral arteries, with or without the use of conduit, that will allow endovascular access with the physician modified endovascular graft.

• Patient has a suitable non-aneurysmal proximal aortic neck of ≥ 2 mm inferior to the most distal renal artery ostium.

• Patient has a suitable non-aneurysmal distal iliac artery length (seal zone) of ≥ 15mm. The resultant repair should preserve patency in at least one hypogastric artery.

• Patient has a suitable non-aneurysmal proximal aortic neck diameter between 20 and 32 mm, averaged across the diameters at the Celiac, SMA, at the lowest patent renal artery and at the midpoint of the renal arteries.

• Patient has suitable non-aneurysmal distal common iliac diameters between 8 and 20 mm.

⁃ Patient has juxtarenal aortic neck angulation ≤ 60°

⁃ Target branch vessel diameter ≥ 5 mm.

⁃ Patient must be willing to comply with all required follow-up exams.