Salvage of bilateral renal artery bridging stent occlusion following inner- branched endovascular aneurysm repair treatment of failing endovascular aneurysm repair - Case report

Endovascular aneurysm repair (EVAR) has transformed the treatment of abdominal aortic aneurysms (AAA). However, complications such as endoleaks may need additional procedures, such as custom-made devices like inner branch endovascular aneurysm repair (iBEVAR). Although these stents have evolved, their uses are not without complications. One of the risks associated with branched devices is branch occlusion and its management. We present a case of bilateral renal artery stent occlusion 18 months following iBEVAR, successfully treated with endovascular intervention using mechanical thrombectomy and re-stenting. This case highlights the importance of immediate recognition and management of renal complications after complex aortic repairs, the role of surveillance imaging, and the feasibility of the endovascular salvage technique, especially in elderly patients with multiple comorbidities.