Endovaskuläre Therapie einer iatrogenen Nierenarterienperforation nach fenestrierter Aortenprothese (fEVAR)

TY - JOUR

T1 - Endovaskuläre Therapie einer iatrogenen Nierenarterienperforation nach fenestrierter Aortenprothese (fEVAR)

AU - Faizy, T

AU - Kamper, L

AU - Meletiadis, K

AU - Kusenack, U

AU - Haage, P

N1 - © Georg Thieme Verlag KG Stuttgart · New York.

PY - 2014/8

Y1 - 2014/8

N2 - HISTORY AND ADMISSION FINDINGS: A 75-year-old patient was initially hospitalized for therapy-evaluation of a an acquaint infrarenal abdominal-aortic-aneurysm, with a maximum diameter of 5.3 cm. Medical history showed a known contained rupture of the aneurysm. Except for a substituted Hypothyroidism and a COPD Stadium II (GOLD), there were no other previous diseases known.EXAMINATIONS: Laboratory showed a slight normochrome, normocytic anemia (hemoglobin 13 g/dl, MCV and MCH were normal) together with a decreased total amount of erythrocytes of 3.89/pl. TSH value was increased significantly at 7.960 mU/l. Initially creatinine was measured at 1.02 mg/dl. Sonography and CT-scan of the abdominal vessels had shown no new insights other than the aneurysm of the abdominal aorta. A surgical revision was indicated.TREATMENT AND COURSE: After primarily uncomplicated implantation of a fenestrated EVAR, the patient showed a progressive hemoglobin loss concomitant with a considerable increase of renal retention parameters. A "spurium"/false aneurysm of the right renal artery was found, which moreover showed a retroperitoneal bleeding. The patient subsequently underwent successful endovascular therapy in our clinic and was dismissed from the hospital in good condition and without further complications. Follow up controls showed no signs of new pathologies.CONCLUSION: "Direct" post-operative complications after EVAR are a rarity. In our case, the interventional endovascular approach of the bleeding from the right renal artery was a successful and sufficient treatment of the potentially life-threatening complication.

AB - HISTORY AND ADMISSION FINDINGS: A 75-year-old patient was initially hospitalized for therapy-evaluation of a an acquaint infrarenal abdominal-aortic-aneurysm, with a maximum diameter of 5.3 cm. Medical history showed a known contained rupture of the aneurysm. Except for a substituted Hypothyroidism and a COPD Stadium II (GOLD), there were no other previous diseases known.EXAMINATIONS: Laboratory showed a slight normochrome, normocytic anemia (hemoglobin 13 g/dl, MCV and MCH were normal) together with a decreased total amount of erythrocytes of 3.89/pl. TSH value was increased significantly at 7.960 mU/l. Initially creatinine was measured at 1.02 mg/dl. Sonography and CT-scan of the abdominal vessels had shown no new insights other than the aneurysm of the abdominal aorta. A surgical revision was indicated.TREATMENT AND COURSE: After primarily uncomplicated implantation of a fenestrated EVAR, the patient showed a progressive hemoglobin loss concomitant with a considerable increase of renal retention parameters. A "spurium"/false aneurysm of the right renal artery was found, which moreover showed a retroperitoneal bleeding. The patient subsequently underwent successful endovascular therapy in our clinic and was dismissed from the hospital in good condition and without further complications. Follow up controls showed no signs of new pathologies.CONCLUSION: "Direct" post-operative complications after EVAR are a rarity. In our case, the interventional endovascular approach of the bleeding from the right renal artery was a successful and sufficient treatment of the potentially life-threatening complication.

KW - Acute Kidney Injury/etiology

KW - Aged

KW - Aneurysm, False/etiology

KW - Aortic Aneurysm, Abdominal/diagnostic imaging

KW - Aortic Rupture/diagnostic imaging

KW - Aortography

KW - Blood Vessel Prosthesis Implantation/adverse effects

KW - Cone-Beam Computed Tomography

KW - Endovascular Procedures/adverse effects

KW - Hemorrhage/etiology

KW - Humans

KW - Iatrogenic Disease

KW - Imaging, Three-Dimensional

KW - Male

KW - Renal Artery/diagnostic imaging

KW - Retreatment

KW - Retroperitoneal Space

KW - Stents

U2 - 10.1055/s-0034-1370231

DO - 10.1055/s-0034-1370231

M3 - SCORING: Journal article

C2 - 25116019

VL - 139

SP - 1707

EP - 1710

JO - DEUT MED WOCHENSCHR

JF - DEUT MED WOCHENSCHR

SN - 0012-0472

IS - 34-35

ER -