Ruptured Abdominal Aortic Aneurysm in a Patient with Congenital Fused Pelvic Kidney: A Case Report of Emergency Endovascular Treatment

Abstract

A 90-year-old male developed acute onset of abdominal and lumbar pain due to the rupture of an 11-cm abdominal aortic aneurysm. A congenital fused pelvic kidney perfused by three renal arteries arising from iliac axes was detected. In an emergent setting, an aorto-uni-iliac endograft was deployed through right femoral surgical access with occlusion of the upper right renal artery. An occluder device was placed in the common iliac artery above the renal artery through left femoral access. A femorofemoral crossover bypass completed the procedure. The patient developed acute renal failure, with no dialysis necessity. One-month computed tomography angiography showed procedure success.

Endovascular Repair of an Inflammatory Abdominal Aortic Aneurysm Combined with a Congenital Pelvic Kidney: Case Report and Literature Review

“…A latest review included 28 patients. 2 We found additionally 18 patients in 17 case reports and one case series ( Table 1 ). All the 46 patients had non-IAAAs.…”

“… 6 CPK and CFPK are associated with aberrant arterial supply originating from different levels of the aorta, the bifurcation, and the iliac arteries. 2 …”

“…The proximal LRA was not opacified, as its orifice was intentionally covered by the graft. Total contrast volume was 260mL and dose area product was 138mGY/3.95MgYm 2 .…”

“…The coexistence of an abdominal aortic aneurysm (AAA) and a CPK is rare, with less than 50 cases reported in the literature. 2 Herein, we report a 66-year-old male with an inflammatory AAA (IAAA) and a coexistent CPK. We were not able to find a similar case with an IAAA in the literature.…”

Thoracic Renal Artery

“…Knowledge of variations in kidney vascular anatomy, in terms of number and origin, is important for patients who are candidates for EVAR, renal transplantation, renal surgery, and/or endovascular treatment. 1 2 3 4 This is crucial to prevent possible complications or errors.…”