Renal artery dissection during repositioning of a mal-deployed aortic endograft with suprarenal fixation.

Endograft mal-deployment during endovascular aneurysm repair (EVAR) may cause renal artery (RA) occlusion. We report bilateral RA occlusion following insertion of an endograft with suprarenal barb fixation. Attempted salvage using the 'pull-down' technique caused right RA dissection. Despite bilateral RA stenting, the right kidney was atrophic on an ultrasound scan at 6 months. This potential hazard of devices with suprarenal barb fixation should be considered when repositioning is attempted.