Bilateral Renal Artery Stent Infection and Pseudoaneurysm Formation

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Presentation transcript:

Bilateral Renal Artery Stent Infection and Pseudoaneurysm Formation Rizwan H. Bukhari, MD, Patrick E. Muck, MD, Francis J. Schlueter, MD, Alan J. Annenberg, MD, L. Richard Roedersheimer, MD, Douglas S. Paget, MD, C.K. Chang, MD, James J. Arbaugh, MD, Richard E. Welling, MD Journal of Vascular and Interventional Radiology Volume 11, Issue 3, Pages 337-341 (March 2000) DOI: 10.1016/S1051-0443(07)61427-4 Copyright © 2000 Society of Interventional Radiology Terms and Conditions

Figure 1 Completion angiography after placement of right (a) and left (b) renal artery stents. Journal of Vascular and Interventional Radiology 2000 11, 337-341DOI: (10.1016/S1051-0443(07)61427-4) Copyright © 2000 Society of Interventional Radiology Terms and Conditions

Figure 2 Carbon dioxide angiograms demonstrating patent left (a) and right (b) renal arteries with stents. Journal of Vascular and Interventional Radiology 2000 11, 337-341DOI: (10.1016/S1051-0443(07)61427-4) Copyright © 2000 Society of Interventional Radiology Terms and Conditions

Figure 3 Abdominal plain film at the time of graft sepsis demonstrates normal stent orientation. Journal of Vascular and Interventional Radiology 2000 11, 337-341DOI: (10.1016/S1051-0443(07)61427-4) Copyright © 2000 Society of Interventional Radiology Terms and Conditions

Figures 4 Abdominal CT scan shows bilateral renal artery pseudoaneurysms with questionable aortic involvement and marked soft tissue inflammatory response. Journal of Vascular and Interventional Radiology 2000 11, 337-341DOI: (10.1016/S1051-0443(07)61427-4) Copyright © 2000 Society of Interventional Radiology Terms and Conditions

Figures 5 Renal angiograms demonstrate bilateral pseudoaneurysms. The right renal artery is occluded distal to the aneurysm. Note the vertical position of the right renal stent, representing a change in position compared to a previous film (see Fig 3). Journal of Vascular and Interventional Radiology 2000 11, 337-341DOI: (10.1016/S1051-0443(07)61427-4) Copyright © 2000 Society of Interventional Radiology Terms and Conditions

Figure 6 Autopsy specimen of abdominal aorta and kidneys removed en bloc. Probes are placed in the renal artery orifices, demonstrating the pseudoaneurysms. Journal of Vascular and Interventional Radiology 2000 11, 337-341DOI: (10.1016/S1051-0443(07)61427-4) Copyright © 2000 Society of Interventional Radiology Terms and Conditions

Figure 7 Microscopy of right renal pseudoaneurysm demonstrates marked acute inflammation (original magnification, ×100). Journal of Vascular and Interventional Radiology 2000 11, 337-341DOI: (10.1016/S1051-0443(07)61427-4) Copyright © 2000 Society of Interventional Radiology Terms and Conditions