Bilateral renal artery occlusion due to intraoperative retrograde migration of an abdominal aortic aneurysm endograft

Image shows an infrarenal abdominal aortic aneurysm. The neck was 13 mm inferior to the lowest renal artery.

Computed tomography slices show the preoperative anatomy of the infrarenal abdominal aortic aneurysm that makes an angulation at the neck region.

Intraoperative angiogram shows the abdominal aortic aneurysm.

Intraoperative angiogram demonstrates (A) the patency of both renal arteries after deployment of the endograft body and (B) occlusion of the vessels after placement of iliac artery extension limb graft. LRA, Left renal artery; RRA, right renal artery; SMA, superior mesenteric artery.

Postoperative computed tomography angiogram demonstrates revascularization of the (A) left and (B) right renal arteries with synthetic graft interposition. LRA, Left renal artery; RRA, right renal artery.

Postoperative 3-dimensional reconstructed computed tomography angiogram demonstrates the aortorenal artery bypass and the bifurcated endograft covering the origins of the renal arteries. LRA, Left renal artery; RRA, right renal artery; SMA, superior mesenteric artery.