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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

The angio-CT scan at the 3-month follow-up showing patency of renal stents and nice perfusion of both kidneys with no evidence of any endoleak.
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fig6: The angio-CT scan at the 3-month follow-up showing patency of renal stents and nice perfusion of both kidneys with no evidence of any endoleak.

Mentions: After 24 hours a transient decline of renal function was noted with an increase of serum creatinine (2.1 mg/dL). The patient's postoperative course was uneventful and renal function returned to baseline within four days (creatinine 1.2 mg/dL). The patient was discharged home on postoperative day 8 and at three months both duplex examination and CT scan revealed patency of renal arteries with no evidence of any types of endoleaks nor recurrent migration of any part of the stent-graft material (Figure 6) and stable serum creatinine.


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)

The angio-CT scan at the 3-month follow-up showing patency of renal stents and nice perfusion of both kidneys with no evidence of any endoleak.
© Copyright Policy - open-access
Related In: Results  -  Collection

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

fig6: The angio-CT scan at the 3-month follow-up showing patency of renal stents and nice perfusion of both kidneys with no evidence of any endoleak.
Mentions: After 24 hours a transient decline of renal function was noted with an increase of serum creatinine (2.1 mg/dL). The patient's postoperative course was uneventful and renal function returned to baseline within four days (creatinine 1.2 mg/dL). The patient was discharged home on postoperative day 8 and at three months both duplex examination and CT scan revealed patency of renal arteries with no evidence of any types of endoleaks nor recurrent migration of any part of the stent-graft material (Figure 6) and stable serum creatinine.

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