Thrombosis of a bifurcated endograft following lower-back microwave therapy

To describe an unusual case involving thrombosis in an aortic endograft limb following microwave therapy (MWT) for lumbar pain.

A 77-year-old man had successful repair of an abdominal aortic aneurysm with a Vanguard endograft. He had been free of complications during the 3-year follow-up. Five days after the 36-month surveillance angiogram, the patient was treated with MWT for chronic left-sided lumbar pain due to vertebral arthrosis. Immediately after this session, the patient presented with acute ischemia in the left lower limb. Computed tomographic angiography showed a thrombosis of the left limb of the endograft. A femorofemoral crossover bypass was performed. No complication was observed in later surveillance.

It may be advisable to avoid MWT and other deep heating therapies in patients with endografts. This caution is applicable to other metallic stents.