Abstract
The patient was a 77-year-old man in whom an abdominal aortic aneurysm was detected on ultrasound images obtained during a health examination. He was admitted to our hospital. We diagnosed an abdominal aortic aneurysm (maximum diameter, 66 mm) and a right common iliac artery aneurysm (maximum diameter, 46 mm) on computed tomography and performed stent graft replacement. However, 11 days after operation, the patient suddenly experienced pain and a cold sensation in the lower right extremity. Early limb occlusion after Endovascular Zenith stent graft placement was diagnosed on computed tomography. The right limb between the distal end and the proximal end of the stent was apparently severely bent and kinked because the right limb moved peripherally after stent graft replacement. The underlying cause was extreme bending and tortuosity of iliac artery, which appeared to be closely related to the patient’s postoperative posture. We performed balloon thrombectomy and self-expandable stenting of the affected region after percutaneous angioplasty. Limb occlusion after stent graft replacement is a serious postoperative complication because it can lead to amputation. It requires quick, appropriate revascularization. Patients with severe bending of the iliac artery are at risk for morphologic changes of the stent graft limb and landing zone and should thus be carefully assessed by imaging studies.
