Intraoperative salvage of a renal artery occlusion during fenestrated stent grafting.
A 79-year-old man with a 6-cm juxtarenal abdominal aortic aneurysm was treated by endovascular means with a fenestrated stent graft. The completion angiogram revealed a left renal artery occlusion. A retroperitoneal surgical approach allowed for retrograde catheterization of the occluded covered stent through the left renal artery. The covered stent was reopened by balloon angioplasty. After 2 months, the left renal artery was patent and renal function normal. At 6 months, both renal arteries were fully open on duplex imaging. The open retroperitoneal approach with retrograde catheterization is a bailout technique to avoid loss of a kidney in fenestrated stent grafting.
Vourliotakis
Georgios
G
Department of Surgery, Division of Vascular Surgery, University Medical Center Groningen, Groningen, The Netherlands.
Blanch
Montse
M
Zeebregts
Clark J
CJ
Cohen
Toby
T
Prins
Ted R
TR
Verhoeven
Eric L G
EL
D000368:Aged; D000800:Angioplasty, Balloon; D017544:Aortic Aneurysm, Abdominal / Q000000981:diagnostic imaging / Q000601:surgery*; D001807:Blood Vessel Prosthesis; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects / Q000295:instrumentation*; D006801:Humans; D007430:Intraoperative Care; D008297:Male; D011474:Prosthesis Design; D015641:Radiography, Interventional; D012078:Renal Artery Obstruction / Q000000981:diagnostic imaging / Q000209:etiology / Q000503:physiopathology / Q000628:therapy*; D016879:Salvage Therapy; D015607:Stents; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014654:Vascular Patency