Endovascular rescue of a maldeployed aortic stent-graft causing renal artery occlusion: technical considerations

The technical success of an endovascular abdominal aortic aneurysm repair depends on the endograft exclusion of the aneurysm along with preservation of flow to major aortic branches, such as the renal or hypogastric artery. A proximally malpositioned aortic endograft may result in inadvertent renal artery occlusion, which may lead to renal infarction with irreversible loss of the renal function. In this report, the authors describe an endovascular rescue technique to salvage a proximally maldeployed aortic endograft that inadvertently covered the renal artery orifice. Physicians performing endovascular aneurysm procedures should be aware of such a salvage maneuver in the event an aortic endograft is proximally maldeployed and occludes the renal artery orifice.