Endovascular Repair of Abdominal Aortic Aneurysm in a Patient with Renal Transplant

Rao, M.; Arya, Nityanand; Lee, B.; Hannon, R.J.; Loan, William; Soong, C.V.

doi:10.1007/s00270-004-0169-3

Cited by 5 publications

(3 citation statements)

References 6 publications

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“…In patients with kidney transplants, a review of the literature shows that endovascular repair has been applied in 14 cases. [10][11][12][13][14][15][16][17][18][19][20][21] In all these patients, the aneurysm remained far from the anastomosis of the kidney artery and did not involve it. In one patient with a ruptured aneurysm, 20 emergency endovascular repair was performed.…”

Section: Discussionmentioning

confidence: 99%

Surgical treatment of aortoiliac aneurysms in renal transplant patients

2008

Journal of Vascular Surgery

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Open repair of aortoiliac aneurysms can be safely undertaken in renal transplant recipients without protection of the transplanted kidney. In the long-term follow-up, these patients are exposed to complications of general arteriosclerosis and to rejection of their transplanted kidney. Aortic aneurysms following kidney transplantation are likely to become more frequent in the future due to extension of renal transplantation to older and severely arteriosclerotic patients.

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Section: Discussionmentioning

confidence: 99%

Surgical treatment of aortoiliac aneurysms in renal transplant patients

2008

Journal of Vascular Surgery

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“…Not surprisingly, these cases have included patients who are renal allograft recipients (Tables 1 and 2). [2][3][4][5][6][7][8][9][10][11][12][13][14][15][16] Despite the increasing wide acceptance of EVAR, not every case can be repaired with stent grafts; in fact, most of the published reports dealing with aneurysms in kidney transplant recipients described open surgical techniques for management (Tables 3 and 4). 2, We herein present a detailed review of our experience and also of the existing literature with regard to the surgical management of aortic aneurysms in renal transplant recipients.…”

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confidence: 99%

“…Aortoiliac Aneurysm Endovascular Repair in Renal Transplant Recipients[2][3][4][5][6][7][8][9][10][11][12][13][14][15][16] All units reported in micromoles per liter were transformed into mg/dL by dividing it by 88. NOTES: AAA ¼ abdominal aortic aneurysm; Cr ¼ serum creatinine; GFR ¼ glomerular filtration rate; HD ¼ hemodialysis; NA ¼ not available; RF ¼ renal failure; tx ¼ transplant.…”

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confidence: 99%

Aortoiliac Aneurysm Repair in Kidney Transplant Recipients

León

Glazer

Hughes

et al. 2008

Vasc Endovascular Surg

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A potential problem during endovascular aortic aneurysm repair (EVAR) or open repair in renal allograft patients is ischemia of the transplanted kidney. In this study, kidney transplant patients who underwent aortic aneurysm repair in our institution were added to similar cases extracted from the literature to represent the basis of this work. Comparisons between patients treated with open surgery versus EVAR were performed in terms of renal function. In the EVAR group, most aneurysms were infrarenal, and 84% were treated with modular bifurcated devices. Protective kidney allograft perfusion measures were not used. The pre- and postoperative Cr was 1.69 and 1.73 mg/dL, respectively (P = .412). All EVAR patients had good outcomes. Complications included 8 endoleaks and 1 limb ischemia case. Three patients died from aortic repair-unrelated reasons. In the open group, the pre-and postoperative Cr was 1.45 and 1.37 mg/dL, respectively (P = .055). Most cases were infrarenal and mostly treated by aortobiiliac bypasses. In 16%, no adjuvant allograft perfusion was provided. In the rest, temporary axillofemoral bypasses were used most often. Most outcomes were favorable (57%). Reported procedural-related complications included arterial embolism, wound infection, and pneumonia. Deaths were reported in 5 occasions (none allograft failure dependent). No differences in Cr between EVAR and open techniques (P = .13) were seen. Aneurysm repair in kidney transplant recipients is associated with excellent renal preservation. Adverse outcomes were all allograft failure independent in both groups. EVAR without special allograft protection measures seems to be equally effective as open surgery with or without adjuvant kidney transplant perfusion.

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