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Accidental Coverage of Both Renal Arteries during Infrarenal Aortic Stent-Graft Implantation: Cause and Treatment.

Bracale UM, Giribono AM, Vitale G, Narese D, Santini G, Del Guercio L - Case Rep Vasc Med (2014)

Bottom Line: Upon completing an angiogram, both renal arteries were found to be accidentally occluded.After three months, both renal arteries were patent and renal function was not different from the baseline.Both endovascular with percutaneous access via the brachial artery and open retroperitoneal approaches with retrograde catheterization are feasible rescue techniques to recanalize the accidentally occluded renal arteries during EVAR.

View Article: PubMed Central - PubMed

Affiliation: Department of Vascular and Endovascular Surgery, University Federico II of Naples, Naples, Italy.

ABSTRACT
The purpose of this paper is to report a salvage maneuver for accidental coverage of both renal arteries during endovascular aneurysm repair (EVAR) of an infrarenal abdominal aortic aneurysm (AAA). A 72-year-old female with a 6 cm infrarenal abdominal aortic aneurysm was treated by endovascular means with a standard bifurcated graft. Upon completing an angiogram, both renal arteries were found to be accidentally occluded. Through a left percutaneous brachial approach, the right renal artery was catheterized and a chimney stent was deployed; however this was not possible for the left renal artery. A retroperitoneal surgical approach was therefore carried out with a retrograde chimney stent implanted to restore blood flow. After three months, both renal arteries were patent and renal function was not different from the baseline. Both endovascular with percutaneous access via the brachial artery and open retroperitoneal approaches with retrograde catheterization are feasible rescue techniques to recanalize the accidentally occluded renal arteries during EVAR.

No MeSH data available.


Related in: MedlinePlus

Preoperative angio-CT scan showing a 6 cm abdominal aortic aneurysm suitable for EVAR.
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Related In: Results  -  Collection


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fig1: Preoperative angio-CT scan showing a 6 cm abdominal aortic aneurysm suitable for EVAR.

Mentions: A 72-year-old female with a 6 cm diameter asymptomatic infrarenal abdominal aortic aneurysm as revealed by previous computed tomography angiography (CTA) measurements (Figure 1) was evaluated for standard EVAR. The patient's clinical history was remarkable for hypertension, hyperlipidemia, and low renal insufficiency (creatinine level of 1.2 mg/dL and BUN 72 mg/dL).


Accidental Coverage of Both Renal Arteries during Infrarenal Aortic Stent-Graft Implantation: Cause and Treatment.

Bracale UM, Giribono AM, Vitale G, Narese D, Santini G, Del Guercio L - Case Rep Vasc Med (2014)

Preoperative angio-CT scan showing a 6 cm abdominal aortic aneurysm suitable for EVAR.
© Copyright Policy - open-access
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4269180&req=5

fig1: Preoperative angio-CT scan showing a 6 cm abdominal aortic aneurysm suitable for EVAR.
Mentions: A 72-year-old female with a 6 cm diameter asymptomatic infrarenal abdominal aortic aneurysm as revealed by previous computed tomography angiography (CTA) measurements (Figure 1) was evaluated for standard EVAR. The patient's clinical history was remarkable for hypertension, hyperlipidemia, and low renal insufficiency (creatinine level of 1.2 mg/dL and BUN 72 mg/dL).

Bottom Line: Upon completing an angiogram, both renal arteries were found to be accidentally occluded.After three months, both renal arteries were patent and renal function was not different from the baseline.Both endovascular with percutaneous access via the brachial artery and open retroperitoneal approaches with retrograde catheterization are feasible rescue techniques to recanalize the accidentally occluded renal arteries during EVAR.

View Article: PubMed Central - PubMed

Affiliation: Department of Vascular and Endovascular Surgery, University Federico II of Naples, Naples, Italy.

ABSTRACT
The purpose of this paper is to report a salvage maneuver for accidental coverage of both renal arteries during endovascular aneurysm repair (EVAR) of an infrarenal abdominal aortic aneurysm (AAA). A 72-year-old female with a 6 cm infrarenal abdominal aortic aneurysm was treated by endovascular means with a standard bifurcated graft. Upon completing an angiogram, both renal arteries were found to be accidentally occluded. Through a left percutaneous brachial approach, the right renal artery was catheterized and a chimney stent was deployed; however this was not possible for the left renal artery. A retroperitoneal surgical approach was therefore carried out with a retrograde chimney stent implanted to restore blood flow. After three months, both renal arteries were patent and renal function was not different from the baseline. Both endovascular with percutaneous access via the brachial artery and open retroperitoneal approaches with retrograde catheterization are feasible rescue techniques to recanalize the accidentally occluded renal arteries during EVAR.

No MeSH data available.


Related in: MedlinePlus