Testicular ischaemia: one of the most unknown of post-EVAR complications

Testicular ischaemia after endovascular aortic aneurysm repair (EVAR) is a very uncommon complication. There are only a few cases reported in the literature and the pathogenesis remains unclear. We report a case of unilateral testicular ischaemia in the early postoperative period after EVAR.A 78-year-old man underwent standard EVAR without immediate complications. Twenty-four hours after the procedure, the patient developed sudden onset of right scrotal pain and a low-grade fever. Urgent testicular ultrasound showed ischaemic signs compromising 75% of the testicle. The patient was successfully managed with conservative treatment.Although the pathogenesis is unknown, acute thrombosis of the testicle feeding arteries is postulated as the main hypothesis in the physiopathogenesis.