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A patient with coral reef aorta at the level of the renal and visceral arteries was treated endovascularly. We used intravascular lithotripsy for improving stent expansion and intravascular ultrasound as an intraoperative diagnostic tool. The renal artery periscope technique maintained renal perfusion after placement of the aortic endograft., Competing Interests: The authors have reported that they have no relationships relevant to the contents of this paper to disclose., (© 2024 The Authors.)