TCTAP C-162 Acute Limb Occlusion of the Endurant II Stent Graft Post Endovascular Repair - The Role of Catheter Directed Thrombolysis

On clinical examination the distal pulses of the left lower limb were absent.Relevant Test Results Prior to Catheterization Doppler US of the left lower limb showed no flow of the SFA, ATA, and DP. CT angiography showed acute thrombus in the left limb of the EVAR graft absent flow down the left lower limb.Relevant Catheterization Findings Acute occlusion of the left EVAR limb graft due to extensive thrombus Kinking of the left limb of the EVAR graft at the aortoiliac junctionInterventional Management Procedural Step Left Lower limb Angiogram done Left Brachial Puncture 6f up size 7f TERUMO STIFF advance with JR 4 catheter support Oclussion of the left EVAR limb noted TERUMO STIFF wire used to cross the occlusion. Left Femoral Artery access closed with PROGLIDE and left brachial access closed with NICHIBANConclusions The patient was maintained on aspirin and Warfarin (INR 2-3) and a follow-up CT angiogram in x 6/12 showed patent EVAR limb.