Endovascular Repair of Abdominal Aortic Aneurysms in the Presence of a Transplanted Kidney

Silverberg, Daniel; Yalon, Tal; Halak, Moshe

doi:10.1007/s00270-014-1027-6

Cited by 9 publications

(2 citation statements)

References 17 publications

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“…Bostock et al did not find any difference in terms of absolute iodinate contrast dose in KTRs that developed postoperative nephropathy and not. However, KTR with renal dysfunction received a significantly higher dose of contrast in relation to the preoperative glomerular filtration ratio (iodine/GFR ratio 0.78 vs 0.39, p = 0.02) [22]. This remark should be taken into account when considering aortic repair in KTRs.…”

Section: Distal Aortic Perfusion With Shunt or Bypassmentioning

confidence: 94%

Renal Transplantation and Aortic Disease: Operative Management

Piffaretti

Tozzi

Franchin

et al. 2019

Visceral Vessels and Aortic Repair

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Section: Distal Aortic Perfusion With Shunt or Bypassmentioning

confidence: 94%

Renal Transplantation and Aortic Disease: Operative Management

Piffaretti

Tozzi

Franchin

et al. 2019

Visceral Vessels and Aortic Repair

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“…8) The advantage of EVAR is avoidance of aortic cross clamp which prevents ischemia and reperfusion injury of the transplanted…”

mentioning

confidence: 99%

Repair of Internal Iliac Artery Aneurysm Anastomosed to Donor Renal Artery in a Renal Transplant Patient

Yamauchi

Takano

Kin

et al. 2016

Annals of Vascular Diseases

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We herein report a successful repair of an internal iliac artery aneurysm in a renal transplant patient. At renal transplantation, the main renal artery and accessory renal artery had been anastomosed to the right internal iliac artery and right external iliac artery, respectively. The patient underwent resection and graft replacement of the iliac artery aneurysm with reattachment of the main renal artery to the right external iliac artery through a midline laparotomy with repeated topical cold perfusion for renal protection. The postoperative course was uneventful, and no evidence of renal function impairment was present at discharge.Keywords: iliac artery aneurysm, renal transplant accessory renal artery of the donor kidney with repeated intermittent topical cold perfusion for protection of the transplanted kidney. Case ReportA 69-year-old female patient had undergone allogeneic renal transplantation in the right iliac fossa 32 years before the current presentation. She subsequently developed multiple cardiovascular events. The patient underwent emergent graft replacement of the ascending aorta and femorofemoral bypass for acute type A dissection 22 years later (the bypass thrombosed before the present operation). The left internal iliac aneurysm was resected, and the distal internal iliac artery was reconstructed with an expanded polytetrafluoroethylene graft 1 year later. Aortic root replacement (Bentall procedure) and total arch replacement were performed for enlargement of the residual aortic dissection and progression of aortic regurgitation 8 years later (1 year before current presentation). Enlargement of the bilateral common iliac arteries (right, 32 mm; left, 33 mm) and right internal iliac artery (30 mm) was subsequently observed. The transplanted kidney was accompanied by an anomaly: an accessory renal artery and triple ureter. End-to-end anastomosis had been performed between the right internal iliac artery and main renal artery, and end-to-side anastomosis had been performed between the right external iliac artery and accessory renal artery for the renal allograft (Fig. 1). The three ureters had been anastomosed to the urinary bladder. The patient took methylprednisolone (4 mg/day) and azathioprine (50 mg/day) in preoperative state.We performed resection and graft replacement of the iliac artery aneurysm through a midline laparotomy as follows. The right femoral artery, right common and external iliac arteries, and transplanted renal artery that had been anastomosed to the internal iliac artery aneurysm were dissected. Additionally, the transplanted renal vein was dissected for drainage of cold perfusate infused from the renal artery to protect the transplanted kidney. The left external iliac artery and internal iliac graft were also dissected.

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