Direct Revascularization with Autotransplant Technique for a True Aneurysm of the Renal Artery 20 Years after Kidney Transplantation

Ann Vasc Surg. 2016 Apr:32:132.e5-8. doi: 10.1016/j.avsg.2015.11.005. Epub 2016 Jan 22.

Abstract

Background: True degenerative aneurysm of renal artery represents a very rare evolution in kidney transplantation. The cases presented in the literature are usually perianastomotic or mycotic pseudoaneurysm related to surgical technical defects or local infections.

Case report: Herewith, we present the case of a voluminous true aneurysm developed in a young patient transplanted at our hospital 20 years before. All follow-up ultrasounds were always normal until the last disclosing a voluminous aneurysm of the transplanted renal artery. The subsequent angio-CT-scan confirmed the presence of a 52-mm saccular dilatation of the renal artery. For the complex anatomy, the endovascular approach was excluded, and a surgical revascularization was staged. We treated this lesion with the autotransplant technique, preserving the transplanted kidney, resecting the aneurysm, and performing a direct anastomosis after cold perfusion of the kidney.

Conclusions: The autotransplant technique demonstrated to be a safe and effective approach in this challenging and very unusual situation.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Anastomosis, Surgical
  • Aneurysm / diagnostic imaging
  • Aneurysm / etiology
  • Aneurysm / surgery*
  • Biopsy
  • Cold Ischemia
  • Computed Tomography Angiography
  • Humans
  • Kidney Transplantation / adverse effects*
  • Male
  • Perfusion
  • Renal Artery / diagnostic imaging
  • Renal Artery / surgery*
  • Renal Veins / diagnostic imaging
  • Renal Veins / surgery*
  • Reoperation
  • Transplantation, Autologous / methods*
  • Ultrasonography, Doppler, Color
  • Vascular Surgical Procedures*