Acute bilateral renal artery chimney stent thrombosis after endovascular repair of a juxtarenal abdominal aortic aneurysm Salvatore T. Scali, MD, Robert.

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Presentation transcript:

Acute bilateral renal artery chimney stent thrombosis after endovascular repair of a juxtarenal abdominal aortic aneurysm Salvatore T. Scali, MD, Robert J. Feezor, MD, Thomas S. Huber, MD, PhD, Adam W. Beck, MD Journal of Vascular Surgery Volume 61, Issue 4, Pages 1058-1061 (April 2015) DOI: 10.1016/j.jvs.2013.10.037 Copyright © 2015 Society for Vascular Surgery Terms and Conditions

Fig 1 A, Three-month post-chimney endovascular aneurysm repair (chEVAR) computed tomography (CT). B, Non-contrasted CT at time of chimney thrombosis. This figure demonstrates the pre- (A) and post- (B) chimney thrombosis axial CT scans. A, This image demonstrates that the 6-mm Atrium iCAST stents never fully expanded to their nominal size. Additionally, there are subtle changes in the conformation of the stents, as evidenced by the short axis configuration and measurements when comparing the two images. Journal of Vascular Surgery 2015 61, 1058-1061DOI: (10.1016/j.jvs.2013.10.037) Copyright © 2015 Society for Vascular Surgery Terms and Conditions

Fig 2 Devices at explantation. This image demonstrates all endovascular devices explanted from the patient's aorta with thrombus within each stent extending into the renal arteries (arrows). Journal of Vascular Surgery 2015 61, 1058-1061DOI: (10.1016/j.jvs.2013.10.037) Copyright © 2015 Society for Vascular Surgery Terms and Conditions

Fig 3 A, Computed tomography (CT) prior to chimney endovascular aneurysm repair (chEVAR). The pre-chEVAR CT demonstrates aneurysmal disease extending above the level of the superior mesenteric artery (SMA) (inset; white arrows), which is above the level of the chosen landing zone for the chEVAR. B, Three-month post-chEVAR CT. The initial post-chEVAR CT demonstrates a kink at the distal end of the Atrium iCAST stent graft that is related to an existing angulation in the native vessel seen on A. Journal of Vascular Surgery 2015 61, 1058-1061DOI: (10.1016/j.jvs.2013.10.037) Copyright © 2015 Society for Vascular Surgery Terms and Conditions