Rapid endovascular bailout revascularization of the renal arteries with a steerable guiding sheath after endovascular abdominal aortic aneurysm repair

Abstract

Advancements in endovascular therapy have made it increasingly available for patients with complex cases but not without complications. Unintentional coverage of the renal arteries is a rare occurrence during endovascular aortic aneurysm repair. Given the potentially devastating repercussions, it is important that surgeons understand the suitability and the risks and benefits of the available revascularization options. We have described two cases of unintentional renal coverage, with subsequent successful bailout via direct manipulation of the stent-graft with a steerable sheath. We also conducted a review of the reported data, discussed the breadth of management options and their technical aspects, and provided several distinct solutions.

Keywords

• Endovascular aneurysm repair
• Accidental coverage
• Renal occlusion
• Bailout
• Chimney grafting
• Parallel grafting