Intraoperative rescue of a dislodged renal stent during fenestrated endovascular aortic repair for treatment of type 1A endoleak

Mario D'Oria; Filippo Griselli; Cristiano Calvagna; Sandro Lepidi

doi:10.1016/j.jvscit.2024.101688

Intraoperative rescue of a dislodged renal stent during fenestrated endovascular aortic repair for treatment of type 1A endoleak

J Vasc Surg Cases Innov Tech. 2024 Nov 20;11(1):101688. doi: 10.1016/j.jvscit.2024.101688. eCollection 2025 Feb.

Authors

Mario D'Oria^{1

2}, Filippo Griselli¹, Cristiano Calvagna¹, Sandro Lepidi^{1

2}

Affiliations

¹ Division of Vascular and Endovascular Surgery, Cardio-Thoracic-Vascular Department, Integrated University Healthcare Giuliano-Isontina, University Hospital of Cattinara, Trieste, Italy.
² Division of Vascular and Endovascular Surgery, Department of Clinical Surgical and Health Sciences, University of Trieste, Trieste, Italy.

Abstract

In the past 15 years, fenestrated-branched endovascular aortic repair (F-BEVAR) has progressively become the first-line option for management of most complex abdominal aortic aneurysms (AAAs); with increasing experience, as well as persistent technological refinements, F-BEVAR indications have been expanded to include rescue of failures after prior EVAR. Despite the feasibility and effectiveness, F-BEVAR procedures in the presence of prior infrarenal endografts may come with higher technical complexity that should be properly anticipated, and several anatomical challenges can be expected. Among these, presence of suprarenal bare stents from prior EVAR device are certainly a frequent scenario and may sometimes make target vessel cannulation more difficult because of encroachment on the target vessel origins. In this manuscript, we report a case intraoperative rescue of a dislodged renal stent during FEVAR for treatment of type 1 endoleak with the aim of showing the culprit of the complication, how to recognize it, and the off-label solution that was devised to solve it.

Keywords: Bridging stent; Complications; Endoleak; Fenestrated endovascular aortic repair.

Publication types

Case Reports