Renal Artery Occlusion After Standard Endovascular Aneurysm Repair: Incidence, Mechanisms, and Individualized Management

Background/Objectives: Direct renal artery compromise after standard endovascular aneurysm repair (EVAR) is rare and may result from mechanical ostial coverage or atheroembolism. We estimated its incidence and described mechanism-specific management and renal outcomes.

Methods

We retrospectively reviewed all consecutive elective standard infrarenal EVAR procedures performed at a single center from March 2016 to June 2025, excluding repairs requiring planned renal incorporation. The primary event was complete renal artery occlusion or severe compromise requiring revascularization. We assessed mechanism, timing, management, renal function, dialysis, target-vessel patency, and survival.