Catheter-delivered Transducer-tipped Ultrasound Thrombolysis of a Chronically Occluded Aortic Stentgraft Limb☆

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Endovascular aneurysm repair (EVAR) is increasingly used to treat infrarenal abdominal aortic aneurysm. EVAR is almost exclusively accomplished by using bifurcated, bi-iliac stentgrafts. Nevertheless, it is accompanied with a considerable incidence of stentgraft limb occlusion. In case of acute occlusion endovascular revascularization options are plentiful, but for chronically occluded stentgraft limbs such consensus is lacking. Catheter-delivered transducer-tipped ultrasound (US) thrombolysis is a new technique specifically coined for the treatment of (sub)acute peripheral arterial occlusions and deep venous thrombosis. We describe a unique case of successful treatment of a chronically occluded stentgraft limb after EVAR with catheter-delivered transducer-tipped US thrombolysis.