title: Suprarenal fixation resulting in intestinal malperfusion after endovascular aortic aneurysm repair.
abstract: Superior mesenteric artery (SMA) and coeliac axis (CA) occlusion after endovascular abdominal aneurysm aortic repair (EVAR-AAA), using endograft with suprarenal fixation, are uncommon. However, we are reporting a case of visceral malperfusion, which occurred 7 days after successful EVAR with suprarenal fixation for symptomatic AAA. Endograft metal stent barbs caused severe stenosis of SMA and CA. A successful recovery of SMA was carried out by means of a balloon-expandable stent released through bare metal stent barbs. We believe that an unfavourable anatomy of a proximal aortic neck and visceral aorta may have caused a wrong stent strut deployment with the coverage of CA and SMA.
authors.affiliation: Vascular and Endovascular Surgery Unit, San Paolo Hospital, Rome, Italy lucamaria.siani@tin.it.
authors.forename: Andrea
authors.initials: A
authors.lastname: Siani
authors.affiliation: Vascular and Endovascular Surgery Unit, San Paolo Hospital, Rome, Italy.
authors.forename: Federico
authors.initials: F
authors.lastname: Accrocca
authors.affiliation: Vascular and Endovascular Surgery Unit, San Paolo Hospital, Rome, Italy.
authors.forename: Gennaro
authors.initials: G
authors.lastname: De Vivo
authors.affiliation: Vascular and Endovascular Surgery Unit, San Paolo Hospital, Rome, Italy.
authors.forename: Giustino
authors.initials: G
authors.lastname: Marcucci
mesh_terms: D000369:Aged, 80 and over; D017544:Aortic Aneurysm, Abdominal / Q000175:diagnosis / Q000601:surgery*; D001807:Blood Vessel Prosthesis; D000072226:Computed Tomography Angiography; D057510:Endovascular Procedures / Q000009:adverse effects*; D005260:Female; D006801:Humans; D007421:Intestine, Small / Q000098:blood supply*; D007511:Ischemia / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D017538:Mesenteric Artery, Superior / Q000000981:diagnostic imaging / Q000601:surgery*; D008641:Mesenteric Vascular Occlusion / Q000150:complications* / Q000175:diagnosis / Q000601:surgery; D012086:Reoperation; D018616:Ultrasonography, Doppler, Duplex
keywords: EVAR; EVAR complications; Suprarenal fixation
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