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Renal Artery Coverage During Endovascular Aortic Aneurysm Repair: Proximal Migration or Misplacement of the Stent-Graft?

Division of Vascular Surgery, University of Cincinnati, Cincinnati, Ohio

Geza Mozes, MD, PhD

Michele Carmo, MD

Division of Vascular Surgery, Gonda Vascular Center, Mayo Clinic, Rochester, Minnesota

James C. Andrews, MD

Thanila A. Macedo, MD

Department of Radiology, Gonda Vascular Center, Mayo Clinic, Rochester, Minnesota

Peter Gloviczki, MD

Division of Vascular Surgery, Gonda Vascular Center, Mayo Clinic, Rochester, Minnesota; gloviczki.peter{at}mayo.edu

Partial or complete coverage of the renal arteries by the stent-graft during endovascular abdominal aortic aneurysm repair is a serious problem. We present two cases with this complication; both were successfully managed using renal artery stents. To minimize the risk of renal artery coverage, completion aortography with good visualization of the renal arteries is recommended. Even a slight increase in serum creatinine after endovascular abdominal aortic aneurysm repair can be a sign of renal artery coverage due to early proximal migration or misplacement during deployment. Computed tomographic scan with and without intravenous contrast is recommended to establish the right diagnosis. Early stenting of the renal arteries is usually possible and associated with an excellent prognosis.

Key Words: Renal artery stenosis • abdominal aortic aneurysm • stent-graft

Perspectives in Vascular Surgery and Endovascular Therapy, Vol. 16, No. 2, 135-140 (2004)
DOI: 10.1177/153100350401600214


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