We report a case of successful surgical management of a potentially life-threatening complication of aortoiliac
stent placement. A 59-year-old man who had
Leriche syndrome underwent bilateral iliac artery and infrarenal aortic
stent placement at another institution. His history was significant for retroperitoneal
lymph node dissection at 19 years of age for
testicular cancer. One week after
stent placement, the patient was readmitted with
abdominal pain, poor oral intake, and diffuse intermittent tenderness. Evaluation with computed tomographic scanning and endoscopy was unremarkable, and the patient was discharged. He was admitted to our institution 1 week later with persistent
abdominal pain. A computed tomographic scan of the abdomen revealed a large
pseudoaneurysm of the abdominal aorta. The patient underwent urgent exploration, and exclusion of his infrarenal aorta was achieved with aortobifemoral bypass grafting. After the operation, the patient's course was complicated by a large paraduodenal
hematoma, which resulted in a
gastric outlet obstruction, which was managed without operation. This case illustrates a potential life-threatening complication of extensive
stent placement for aortoiliac occlusive disease. Injury to the abdominal aorta must be considered in a symptomatic patient after the placement of
stents in the aortoiliac region, beyond the immediate periprocedural period.