Endovascular salvage of the hypogastric artery using iliac branch device (IBD) duringendovascular aortic aneurysm repair (EVAR), offers less invasive alternative solution tosurgery to prevent pelvic ischemia. We have performed the first Korean surgeon custommadeIBD for this purpose to overcome the limitation of unavailability of the devices inKorea. Four patients with abdominal aortic aneurysm with bilateral common iliac arteryaneurysm (CIAA) were treated using custom-made IBDs from October 2013 to December2013. IBD was created in back table before EVAR operation using TFLE Zenith iliac limbstent graft (Cook Inc.). Three V12 (Atrium, Inc.) one Viabahn (Gore, Inc.) were used forbridging between IBD and target hypogastric artery. With this modification of IBDprocedure, exteriorize the guide wire without snare device is possible which offers anotherbenefit in terms of reducing medical costs comparing to commercial IBD. All operationswere successful without any device related complications or postoperative endoleaks. During the mean follow up of 3 months, all IBD were patent without clinicalcomplications. Surgeon custom made IBD is feasible and useful to preserve pelvic perfusionespecially in the situation of limited commercial IBD availability in many countries. Longtermfollow-up is needed to evaluate stent graft patency and IBD-related complications.