Techniques for removing bilateral renal artery stents prior to fenestrated endovascular aneurysm repair.
OBJECTIVE
To demonstrate 2 endovascular methods for successful intravascular stent extraction.


METHODS
In preparation for fenestrated endovascular aneurysm repair, renal artery stents may be implanted for focal vessel stenosis at the ostium. In a recent case, bilateral renal artery stents were deployed with >50% protruding into the aortic lumen, thus rendering fenestrated endografting impossible. Two techniques were employed to extract the stents. In the left renal artery, the stent was extracted using an endovascular snare, but the right renal artery stent could not be removed with this method. Instead, an endoscopic forceps was advanced down a 16-F sheath, and the stent was grasped, extracted, and released into the aneurysm sac. The endovascular repair then proceeded in the usual fashion.


CONCLUSIONS
The need to remove a stent prior to endovascular aneurysm repair is not a common problem encountered by most endovascular specialists; however, these methods should be in their armamentarium should the need arise.
The Multidisciplinary Endovascular Team, University College London Hospital, London, UK.
Luke
L
Morgan-Rowe
Dominic
D
Simring
Jowad
J
Raja
Obi
O
Agu
Krassi
K
Ivancev
Julian
J
Hague
D000368:Aged; D000800:Angioplasty, Balloon / Q000295:instrumentation*; D017544:Aortic Aneurysm, Abdominal / Q000000981:diagnostic imaging / Q000601:surgery*; D001027:Aortography / Q000379:methods; D001807:Blood Vessel Prosthesis; D019917:Blood Vessel Prosthesis Implantation / Q000295:instrumentation*; D020878:Device Removal; D057510:Endovascular Procedures / Q000295:instrumentation*; D006801:Humans; D008297:Male; D011474:Prosthesis Design; D015641:Radiography, Interventional; D012077:Renal Artery / Q000000981:diagnostic imaging; D012078:Renal Artery Obstruction / Q000628:therapy*; D015607:Stents; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome