Something is not right - Image 2

Image in Interventional Cardiovascular Medicine: what is displayed on this image? ... and do not hesitate to comment how you would treat this case!

A septuagenarian patient with a history of smoking, hypertension, chronic non-dialysis renal failure who presented an 8.0 cm thoracoabdominal aortic aneurysm involving the iliac arteries...

An image is worth a 1000 words: tell us how would you treat!

What is really happening to this patient? And which of the following treatments do you think has been proposed?

1. Previously treated abdominal aortic aneurysm with bifurcated endoprosthesis implanted. The patient suffered closed abdominal trauma and prosthesis disconnections occurred. Abdominal aneurysm rupture is imminent. Open surgery is indicated because it is exceedingly difficult to remake connections, the main body and extensions being totally misaligned.
2. The patient had normal abdominal aorta and thoracic and iliacs arteries aneurysms treated with modular prosthesis, causing a peculiar image. No treatment is needed.
3. There was a thoracoabdominal aneurysm treated with multilayer prosthesis and because of aorta tortuosity a disconnection occurred. An approach with multiple vascular accesses in addition to the use of a directable sheath and varal technique and other multilayer prosthesis should be implanted.

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