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

Patil, Vivek V.; Roytman, Michelle; Ames, Scott; Beckerman, William E.; Lookstein, R.

doi:10.1007/s00270-015-1136-x

Cited by 7 publications

(5 citation statements)

References 9 publications

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“…These show promise in transplant-sparing procedures as well. 20,21 Sonography-guided thrombin injection can be used alone or alongside covered stent placement, if the pseudoaneurysm neck is small. 22 Left untreated, RTAPs create serious complications.…”

Section: Discussionmentioning

confidence: 99%

Sonographic Assessment of Renal Transplant Anastomotic Pseudoaneurysm: A Case Study

Petersen

Hunt

McMenomy

et al. 2022

Journal of Diagnostic Medical Sonography

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Renal transplant anastomotic pseudoaneurysms (RTAPs) are a rare vascular postoperative complication. The etiology of these pseudoaneurysms is attributed to infection or surgical vessel damage. RTAPs can lead to allograft dysfunction, allograft loss, or patient mortality due to rupture or sepsis. Because of these serious complications, expedient diagnosis is imperative for initiating surgical intervention and medical management. Sonography is a useful imaging modality for diagnosing and characterizing RTAPs. The sonographic findings, although not often described in detail in the literature, are definitive and unique. This case report describes the sonographic findings of a patient 22 days post renal autotransplant, who presented with excruciating abdominal pain. Sonographic examination identified multiple classic pseudoaneurysm findings and demonstrated intrarenal and extrarenal vascular abnormalities.

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Section: Discussionmentioning

confidence: 99%

Sonographic Assessment of Renal Transplant Anastomotic Pseudoaneurysm: A Case Study

Petersen

Hunt

McMenomy

et al. 2022

Journal of Diagnostic Medical Sonography

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“…Treatments for EPSAs include open surgical repair, endovascular approach and ultrasound-guided thrombin injection. In the last decade, the endovascular approach has become more popular for EPSAs[ 19 , 24 , 25 ], which reduces the risk of rupture by excluding blood flow into the EPSAs with stent placement.…”

Section: Discussionmentioning

confidence: 99%

Diagnosis and spontaneous healing of asymptomatic renal allograft extra-renal pseudo-aneurysm: A case report

Xu¹,

He²,

Yi³

et al. 2021

WJCC

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BACKGROUND Transplant renal artery stenosis is a relatively frequent vascular complication after transplantation. However, extra-renal pseudo-aneurysms (EPSAs) are rare after transplantation; they can be life-threatening and usually need open surgical repair. We discuss the diagnosis and spontaneous healing of an asymptomatic renal allograft EPSA caused by renal artery anastomotic stenosis, which was diagnosed in a timely manner and managed by conservative treatments. CASE SUMMARY We present a 37-year-old male patient diagnosed with a renal allograft EPSA caused by renal artery anastomotic stenosis due to multiple atherosclerotic plaques with ultrasonographic examination 6 mo post transplantation. The stenosis rate of 90% and the EPSA were verified by computed tomography angiography. The diagnosis was further confirmed with digital subtraction angiography. Percutaneous transluminal angiography was conducted, and a metallic stent was successfully implanted at the stenosed site of the main renal artery trunk. No further intervention for the EPSA was undertaken due to the difficulty of stenting and the risk of bleeding; regular ultrasonographic follow-ups were recommended. The stenosis was significantly relieved immediately after stent implantation and the EPSA was healed spontaneously by completely filling with hypo-echoic thrombosis 8 mo after stenting. CONCLUSION Ultrasonography combined with a high-frequency linear probe can detect vascular complications post renal transplantation at an early stage and improve prognosis.

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“…1,7 Because of the deep anastomotic site and the occlusion of transplanted kidneys, open surgery can easily injure the kidney, and allografts are lost in many cases. 8 The main methods for endovascular treatment include coils, covered stents, and embolic agents. 2,9 However, due to the complex anatomical relationship of the local blood vessels, successful occlusion of the aneurysm and preservation of the function of the transplanted kidney are difficult.…”

Section: Discussionmentioning

confidence: 99%

Retrospective evaluation of the endovascular repair of the anastomotic pseudoaneurysm of the transplanted renal artery using the snorkel technique

Che

Song

et al. 2020

Vascular

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Objective To evaluate the endovascular repair of the transplanted renal artery anastomotic pseudoaneurysm using the snorkel technique. Methods From April 2012 to December 2017, we performed endovascular repair in six patients, who were diagnosed with transplanted renal artery anastomotic pseudoaneurysm, using the snorkel technique. The “snorkel” stent and the “parallel” stent were placed in the transplanted kidney and the external iliac artery, respectively. Another covered stent was implanted at the proximal end of the external iliac artery to match the diameter of the iliac artery. Result and conclusion: Of the six patients, three patients recovered. Two patients experienced pseudoaneurysm rupture due to infection, and one patient developed stent thrombosis; all three patients underwent graft nephrectomy. The endovascular treatment of transplanted renal artery anastomotic pseudoaneurysm with the snorkel technique is a feasible method but needs to comply with certain indications.

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

Cited by 7 publications

References 9 publications

Sonographic Assessment of Renal Transplant Anastomotic Pseudoaneurysm: A Case Study

Sonographic Assessment of Renal Transplant Anastomotic Pseudoaneurysm: A Case Study

Diagnosis and spontaneous healing of asymptomatic renal allograft extra-renal pseudo-aneurysm: A case report

Retrospective evaluation of the endovascular repair of the anastomotic pseudoaneurysm of the transplanted renal artery using the snorkel technique

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