Renal Stent Graft Migration Following Chimney Endovascular Aneurysm Repair

Area of Science:

• Vascular Surgery
• Endovascular Interventions
• Aortic Aneurysm Management

Background:

• Pararenal abdominal aortic aneurysms (PAAAs) pose complex management challenges.
• Chimney endovascular aneurysm repair (ChEVAR) offers a minimally invasive approach for complex aortic pathologies.

Observation:

• A 78-year-old male experienced progressive enlargement of a PAAA post-ChEVAR.
• Aneurysmal expansion was linked to endoleak from left renal artery chimney stent graft migration.
• A 5-mm increase in aneurysm diameter was noted over six months.

Findings:

• Endovascular reintervention successfully achieved aneurysm regression.
• Annual imaging follow-up confirmed no recurrence of endoleak.
• The case demonstrates successful management of ChEVAR complications.

Implications:

• Vigilance for stent graft migration is crucial in ChEVAR for PAAAs.
• ChEVAR is a viable option for complex aortic aneurysms, but requires careful surveillance.
• Long-term monitoring is essential to ensure the durability of ChEVAR outcomes.