Strategies to Tackle Unrecognized Bilateral Renal Artery Occlusion After Endovascular Aneurysm Repair

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• 作者：John Adu¹ ; Nicholas J. Cheshire¹ ; ² ; Celia V. Riga¹ ; ² ; Mohamad Hamady³ ; Colin D. Bicknell¹ ; ² ; ^{colin.bicknell@imperial.ac.uk}
• 刊名：Annals of Vascular Surgery
• 出版年：2012
• 出版时间：November, 2012
• 年：2012
• 卷：26
• 期：8
• 页码：1127.e1-1127.e7
• 全文大小：821 K

文摘

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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¡ªthe choice of procedure is primarily determined by accessibility of the renal orifice.