Adu J, Cheshire NJ, Riga CV, Hamady M, Bicknell CD. Strategies to tackle unrecognized bilateral renal artery occlusion after endovascular aneurysm repair.
Ann Vasc Surg 2013;
26:1127.e1-7. [PMID:
23068430 DOI:
10.1016/j.avsg.2012.02.018]
[Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2011] [Revised: 02/14/2012] [Accepted: 02/15/2012] [Indexed: 01/31/2023]
Abstract
BACKGROUND
Unintentional renal artery occlusion after endovascular aortic aneurysm repair (EVAR) is an uncommon phenomenon. The sequelae from this specific complication are severe; consequently, the topic of renal artery coverage is a pertinent issue. We present a case series of patients undergoing EVAR with unintentional renal artery coverage, review the treatment options available, and suggest a treatment algorithm for this scenario based on the evidence.
METHODS AND RESULTS
We report four patients who were found to have renal artery occlusion after EVAR detected up to 5 weeks postoperatively. Renal revascularization was achieved using endovascular renal artery stenting in two patients, and open hepato-spleno-renal bypass in the remaining two cases. Treatment strategies used led to symptom resolution and recovery of renal function in all cases.
CONCLUSIONS
Both open and endovascular techniques may be used as procedures to treat this condition-the choice of procedure is primarily determined by accessibility of the renal orifice.
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