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About: The aim of this report is to discuss emergent repair for complex aortic diseases in patients affected by novel coronavirus pneumonia (COVID-19), describing a case of ruptured pararenal aortic aneurysm. A COVID-19, eighty-years-old man was admitted for ruptured aneurysm of the pararenal aorta and hemorrhagic shock. Endovascular repair was chosen and a proximal extension of the previous abdominal endograft was performed with parallel stents in the right renal artery and the superior mesenteric artery. Endovascular treatment and early anticoagulation are the key for success for vascular emergencies in COVID-19 patients, despite the risk of late endoleak.

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