Multiple complications after aortic stent-graft placement in a patient with preexisting nephrostomy and atherosclerosis of the lower extremities

Summary Background: Aortic stent-graft placement is intended to be a procedure with minimal perioperative risk in com -parison to the open procedure. However, the 1.5% mortality rate and the possibility of procedure-related complications should be taken into account. Case Report: This paper presents multiple procedure-related complications including acute limb ischemia and bowel necrosis in a patient with preexisting nephrostomy operated on with EVAR (endovascular aortic repair). Issues regarding proper anatomical planning and imaging are discussed, and ways to avoid such complications are highlighted. Conclusions: Multiple complications during EVAR may significantly reduce the early benefit of the procedure. Correct preoperative assessment of CT scans can avoid making an inappropriate decision regard-ing use of EVAR. In cases of concomitant urological pathology, any surgical intervention should be decided upon in cooperation with the vascular surgeon and urologist.