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Case Reports
. 2020 Oct 15;15(12):2655-2659.
doi: 10.1016/j.radcr.2020.10.011. eCollection 2020 Dec.

Endovascular repair for abdominal aortic aneurysm in a kidney transplant recipient

Vu Tri Thanh  1 , Ho Tat Bang  2   3 , Nguyen Dinh Phat  1 , Lam Thao Cuong  1   2 , Le Quang Dinh  2 , Tran Thi Mai Thuy  4 , Tran Thanh Vy  1   2
Affiliations
Case Reports

Endovascular repair for abdominal aortic aneurysm in a kidney transplant recipient

Vu Tri Thanh et al. Radiol Case Rep. .

Abstract

Surgical treatment of abdominal aortic aneurysm in patients with a transplanted kidney is true a challenge. Conventional open repair of the aneurysm requires aortic cross-clamping. Therefore, it can pose a risk of ischemic injury to the transplanted kidney. Endovascular repair, which limits the duration of interruption of blood flow to the transplanted kidney, is a suitable alternative for repair of abdominal aortic aneurysm, if feasible anatomically. Here, we present a case of a 62-year-old woman who was transferred to our hospital because of abdominal pain and had a history of renal transplant 14 years ago. Computed tomography confirmed a large infrarenal fusiform abdominal aortic aneurysm 6 cm in maximal diameter and another 4 cm fusiform aneurysm in the left common iliac artery. We successfully performed endovascular aneurysm repair combined with femoro-femoral bypass. The postoperative course was uneventful, and the patient was discharged on the 5th postoperative day.

Keywords: Abdominal aortic aneurysms; Endovascular aneurysm repair; Kidney transplant recipient.

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Figures

Fig 1
Fig. 1
Abdominal CT images. (a) Axial and (b) Coronal images obtained in the arterial phase show a large abdominal aortic aneurysm with intramural thrombus. (c) Axial and (d) coronal views obtained in the arterial phase shows a large left iliac aneurysm with calcified intramural thrombus. The transplanted kidney was also noted in the right lower quadrant.
Fig. 2
Fig. 2
Coronal volume render images: Anteroposterior (a) and posteroanterior (b) views show a large aortic and left iliac aneurysm with calcified intramural thrombus. The left external iliac artery angulated severely (green arrow).
Fig. 3
Fig. 3
The three-dimension analysis was done with Mensio Vascular 10.1 software to obtain the sizing and planning for EVAR.
Fig. 4
Fig. 4
(a) Preintervention angiography; (b) Aorto-uni-iliac stent graft was expanded from infra abdominal aorta to right common iliac artery combined with occlusion of contralateral common iliac by coils (c).
See this image and copyright information in PMC

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