Intraoperative cephalad migration of endovascular aortic repair endograft resulting in bilateral renal artery coverage.

Migration of an endovascular stent graft covering the renal arteries after endovascular aortic repair is a rare but serious complication. We present the case of a 73-year-old man who developed flank pain, oliguria, and a rise in serum creatinine to 4.09 mg/dL on postoperative day 2 following endovascular aortic repair for an infrarenal abdominal aortic aneurysm. The patient was then transferred to our hospital for further management. He was successfully treated with bilateral renal artery stenting through the brachial approach, adequately restoring renal artery perfusion more than 72 hours after his index procedure. The patient tolerated the procedure well and was discharged without significant complications. Follow-up demonstrated sustained renal recovery, with a stable serum creatinine of 1.13 mg/dL. This case presents a rare complication of excluder endograft deployment and highlights the need to be cognizant during limb cannulation and deployment.