Limb occlusion after endovascular repair of an abdominal aortic aneurysm: beware the narrow distal aorta

Abstract

We suggest clinicians should be aware of this potential pitfall during EVAR planning and beware the narrow distal aorta.

Clinical outcome and morphologic analysis after endovascular aneurysm repair using the Excluder endograft

“…[29][30][31][32] Our cohort had few occlusive complications, occurring exclusively in patients with narrow aortic bifurcations, a known risk factor for occlusion. 33 Data for European Collaborators on Stent-Graft Techniques for Aortic Aneurysm Repair (EUROSTAR) and single-center reports further support the good performance of this device in adverse iliac anatomy, 33-35 but this was not directly evaluated in our population.…”

Outcomes of Endurant stent graft in narrow aortic bifurcation

“…11 Narrow distal aorta represents a risk factor for limb endograft occlusion. 12 As a consequence, some authors experimented with conventional or off-label techniques to overcome this critical anatomic condition. 13,14 Up to now, no study demonstrated the safety and effectiveness of this new-generation endograft in narrowed aortic bifurcation.…”

Percutaneous endovascular abdominal aneurysm repair: State‐of‐the art

“…In addition to the risk of endograft limb occlusion in a narrow distal aorta, contralateral gate cannulation of modular proximal fixation devices can be challenging . While aggressive balloon dilatation is important in narrow distal aortic anatomy, limb impingement can still occur and may require surgical intervention . Distal fixation unibody and custom‐made step‐down diameter grafts can be used to avoid this potential complication …”

“…27 While aggressive balloon dilatation is important in narrow distal aortic anatomy, limb impingement can still occur and may require surgical intervention. 28 Distal fixation unibody and custom-made step-down diameter grafts can be used to avoid this potential complication. 27,29,30…”