title: Combined surgical and endovascular removal of thrombus entirely occluding a bifurcated aortic stent-graft.
abstract: OBJECTIVE
  To explore a method combining interventional, endovascular, and conventional surgical techniques for treating a completely occluded bifurcated stent-graft after endovascular aortic aneurysm repair.
  
  
  RESULTS
  A 60-year-old patient underwent endovascular repair of an abdominal aortic aneurysm (AAA) with a Talent bifurcated stent-graft. Five months later, after chronic thrombotic occlusion of the right iliac limb, he presented with acute occlusion of the entire stent-graft. Local intra-arterial infiltration thrombolysis successfully reconstituted flow through the main aortic segment and left iliac limb. With a combination of conventional surgical and intraoperative endovascular procedures, thrombectomy and recanalization of the right iliac limb was completed by stenting a severe stenosis of the proximal iliac limb.
  
  
  CONCLUSIONS
  A combination of techniques may be essential for successful management of thrombotic complications after endovascular AAA repair.
authors.affiliation: Clinic of Surgery, Humboldt University Medical School (Charité), Berlin, Germany.
authors.forename: R I
authors.initials: RI
authors.lastname: Rückert
authors.forename: P
authors.initials: P
authors.lastname: Romaniuk
authors.forename: P
authors.initials: P
authors.lastname: Rogalla
authors.forename: T
authors.initials: T
authors.lastname: Thieme
authors.forename: T
authors.initials: T
authors.lastname: Umscheid
authors.forename: W J
authors.initials: WJ
authors.lastname: Stelter
authors.forename: J M
authors.initials: JM
authors.lastname: Müller
mesh_terms: D000208:Acute Disease; D000792:Angiography; D017544:Aortic Aneurysm, Abdominal / Q000601:surgery*; D019917:Blood Vessel Prosthesis Implantation; D002908:Chronic Disease; D006083:Graft Occlusion, Vascular / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D015607:Stents; D017131:Thrombectomy / Q000379:methods*