Endograft Limb Occlusion after Endovascular Aneurysm Repair

Joo, Yoon Sung

Abstract

Endovascular aneurysm repair (EVAR) has been increasingly used in order to treat infrarenal aortic aneurysms. However, there have been various complications and adverse events such as endoleak, graft migration, continued aneurysm expansion, and endograft limb occlusion (ELO). I have experienced a case of ELO. In order to treat it, I performed a thrombectomy using a 5F Fogarty catheter and a 12 mm balloon angioplasty. Thus, I report the results of treatment with the review of journals. The case involves a 54 year-old male who was treated Abdominal Aovtic Aneurysm (AAA) through EVAR. There was no definite anatomic contraindication for EVAR. The Zenith Flex was used and there was no specific problem during the EVAR procedure. At 6 months following EVAR, acute onset of cyanosis and coldness developed in the left leg. To minimize arterial wall injury and avoid endograft migration during balloon cather thrombectomy, fluoroscopically assisted thromboembolectomy was completed. After thromboembolectomy, balloon angioplasty was done in the stenotic lesion of the endograft. The ischemic symptoms (cyanosis, rest pain, coldness) improved after the procedures.