Multiple complications after aortic stent-graft placement in a patient with preexisting nephrostomy and atherosclerosis of the lower extremities
Michal Stanisic, Natalia Majewska
Am J Case Rep 2011; 12:76-79
Background: Aortic stent-graft placement is intended to be a procedure with minimal perioperative risk in comparison to the open procedure. However, the 1.5% mortality rate and the possibility of procedure-related complications should be taken into account.
Case Report: This paper presents multiple procedure-related complications including acute limb ischemia and bowel necrosis in a patient with preexisting nephrostomy operated on with EVAR (endovascular aortic repair). Issues regarding proper anatomical planning and imaging are discussed, and ways to avoid such complications are highlighted.
Conclusions: Multiple complications during EVAR may significantly reduce the early benefit of the procedure. Correct preoperative assessment of CT scans can avoid making an inappropriate decision regarding use of EVAR. In cases of concomitant urological pathology, any surgical intervention should be decided upon in cooperation with the vascular surgeon and urologist.
Keywords: abdominal aortic aneurysm complications, aortic stentgrafts, nephrostomy, bowel necrosis, acute limb ischemia