Endovascular treatment of a giant aorto-ostial renal artery pseudoaneurysm

Vascular complications after lumbar laminectomy are rare, but are potentially life-threatening. A 59-year-old man presented with progressive and worsening abdominal pain over several weeks. Multidetector computed tomography angiography revealed a large aorto-ostial left renal artery pseudoaneurysm 3 years after lumbar laminectomy. The pseudoaneurysm was successfully treated with a combination of various endovascular techniques ("jailed" microcatheter technique, stent-graft implantation, thrombin injection, balloon remodeling technique, Onyx application), with preserved patency of the left renal artery and pseudoaneurysm exclusion on 6-month follow-up multidetector computed tomography angiography. The size and location of this pseudoaneurysm and the combination of different techniques for endovascular treatment provides an update on current endovascular technology. Combination of different endovascular techniques can be a safe and feasible alternative for the treatment of complicated iatrogenic postlaminectomy vascular injuries and renal artery pseudoaneurysms.