Endovascular repair of a transplant renal artery anastomotic pseudoaneurysm using the snorkel technique

Che, H.; Men, Changping; Mi, Yang; Zhang, Ju‐Wen; Chen, Ping; Yong, Jun

doi:10.1016/j.jvs.2013.07.016

Cited by 21 publications

(23 citation statements)

References 12 publications

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“…Patients with transplant renal artery anastomotic pseudoaneurysms are often asymptomatic, presenting as incidental findings on duplex ultrasound or CT scans [7]. Others may present with pulsatile masses on physical exam or pain, as with our patient.…”

Section: Discussionmentioning

confidence: 60%

“…In our patient, the open surgical approach was particularly suboptimal due to extensive prior pelvic surgery and [7].…”

Section: Discussionmentioning

confidence: 85%

“…In the absence of infection, many providers believe conservative management is possible for small asymptomatic pseudoaneurysms [8]. Repair is thought to be indicated for pseudoaneurysms that are symptomatic, larger than 2.5 cm, showing significant growth, or confirmed to be caused by infection [7].…”

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Endovascular Repair of Renal Artery Anastomotic Pseudoaneurysm Following Living Donor Kidney Transplant

Patil

Roytman

Ames

et al. 2015

Cardiovasc Intervent Radiol

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Renal artery anastomotic pseudoaneurysms, an uncommon complication of transplantation, may result in aneurysm rupture and loss of allograft. We report the case of 50-year-old female with back pain 3 weeks post renal transplantation. CT scan revealed transplant renal artery anastomotic pseudoaneurysm arising from anastomosis of two renal arteries joined together to form a single renal artery that was joined to the aorta. Successful endovascular treatment was achieved with covered stents, resulting in preserved renal function. Follow-up ultrasound at one-day post procedure and CT at 2 months revealed satisfactory renal perfusion with no pseudoaneurysm. Endovascular treatment of transplant renal artery pseudoaneurysms with covered stent and ostial flare balloon technology may be preferred in patients with extensive prior pelvic surgery, as illustrated in this case.

show abstract

Section: Discussionmentioning

confidence: 60%

“…In our patient, the open surgical approach was particularly suboptimal due to extensive prior pelvic surgery and [7].…”

Section: Discussionmentioning

confidence: 85%

See 1 more Smart Citation

Endovascular Repair of Renal Artery Anastomotic Pseudoaneurysm Following Living Donor Kidney Transplant

Patil

Roytman

Ames

et al. 2015

Cardiovasc Intervent Radiol

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“…There are recent isolated published cases of endovascular treatment with covered stents with Chimney and Periscope techniques with successful preservation of renal graft; however, they are only possible with a very favorable iliac anatomy without infection. Endovascular treatment can be useful in emergent AP rupture to control active bleeding in unstable patients as a bridge to surgery.…”

Section: Discussionmentioning

confidence: 99%

Renal transplant anastomotic pseudoaneurysms: Case report of open repair and endovascular management

et al. 2019

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Introduction Anastomotic pseudoaneurysm is one of the rarest vascular complications after renal transplant surgery. Therapeutic options include open surgical repair or endovascular stenting. Case presentation Case 1 had pseudoaneurysm involving external iliac artery and was managed by jump graft to allograft using cadaveric donor iliac arteries and patch angioplasty repair of external iliac artery after excising pseudoaneurysm. Case 2 had undergone orthotopic renal transplant with spleno‐renal arterial anastomosis and developed a massive pseudoaneurysm proximal to spleno‐renal arterial anastomosis. This patient underwent endovascular stenting preserving allograft vascularity and graft function. Outcome in both patients was successful with normalization of renal function to baseline levels. Conclusion Treatment of renal transplant anastomotic pseudoaneurysms is difficult and associated with high rates of graft loss. Open surgery is the gold standard providing several possibilities for arterial reconstruction preserving graft and limb circulation. Endovascular treatment should be considered in high‐risk surgical patients with favorable anatomy.

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“…Treatment indications for pseudoaneurysms include size greater than 2.5 cm, increasing in size, presence of symptoms, and rupture (1,5). Treatment options include percutaneous thrombin injection for smaller pseudoaneurysms, endovascular approach with stenting to exclude the pseudoaneurysm, and surgical excision (5)(6)(7)(8)(9). We favored a surgical intervention based on the size of the pseudoaneurysm, proximity to the renal artery anastomosis, impending rupture, and compression of the renal vein.…”

Section: Discussionmentioning

confidence: 99%

Treatment of large renal allograft arterial pseudoaneurysm with in situ cold perfusion, ex vivo vascular reconstruction and reimplantation

et al. 2018

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Background: Pseudoaneurysm after renal transplantation is a rare but serious complication. Case Presentation: We report a case of a 76-year-old man who presented six weeks after kidney transplant with a large pseudoaneurysm arising from the renal artery anastomosis, causing renal vein compression and renal allograft dysfunction. Prior to the removal of the transplanted kidney, an in situ cold perfusion of the allograft was performed. The pseudoaneurysm was repaired ex vivo and the renal artery was reconstructed. External iliac vein was reconstructed with deceased donor interposition allograft, and the kidney was then re-implanted. The patient recovered with immediate allograft function. Conclusions: Successful surgical management of a large renal allograft arterial pseudoaneurysm involves avoidance of dissection of the pseudoaneurysm, utilization of in situ cold perfusion and en-bloc removal of the kidney together with pseudoaneurysm, and pseudoaneurysm incision and vascular bypass reconstruction ex vivo

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Endovascular repair of a transplant renal artery anastomotic pseudoaneurysm using the snorkel technique

Cited by 21 publications

References 12 publications

Endovascular Repair of Renal Artery Anastomotic Pseudoaneurysm Following Living Donor Kidney Transplant

Endovascular Repair of Renal Artery Anastomotic Pseudoaneurysm Following Living Donor Kidney Transplant

Renal transplant anastomotic pseudoaneurysms: Case report of open repair and endovascular management

Treatment of large renal allograft arterial pseudoaneurysm with in situ cold perfusion, ex vivo vascular reconstruction and reimplantation

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