A Case of a Right Renal Artery Aneurysm Treated with a Stent Graft through a Stent Migrated into the Aneurysmal Sac: A Case Report

We report a case of a right renal artery aneurysm treated with a stent graft through a previously placed stent. The patient was 30-year-old male presented with a renal artery aneurysm located in the right main renal artery. The saccular aneurysm was 2 cm in diameter and with a wide neck. Although coil embolization using a stent-assisted technique was performed in a previous hospital, proximal edge of the stent was migrated into the aneurysmal sac and the procedure was abandoned. The patient was referred to our institute to receive additional endovascular treatment. Exclusion of the aneurysm placing a balloon-expandable stentgraft on the parent artery through a stent cell was planned. A 7-French guiding sheath was introduced via the right femoral artery and advanced to the proximal right renal artery. A flexible guidewire was advanced to the distal renal artery through a stent cell, and it was exchanged for a stiffed guidewire using a catheter. A delivery system of the stent graft was inserted under the stiffed guidewire; however, a tip of the delivery system was caught in the edge of a stent strut and was not passed through the stent cell, even after dilation of the stent cell using a balloon catheter. After changing the guidewire to a thin, flexible guidewire, the delivery system passed successfully through the stent cell and exclusion of the aneurysm was achieved.

Publication History

Article published online:
26 April 2021