External iliac artery pseudoaneurysm complicating renal transplantation

Bracale, Umberto; Carbone, Francesca; Guercio, Luca del; Viola, Daniela; D’Armiento, Francesco Paolo; Maurea, Simone; Porcellini, M; Bracale, Giancarlo

doi:10.1510/icvts.2008.200386

Cited by 48 publications

(55 citation statements)

References 20 publications

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“…1 True pseudoaneurysms at the donor renal, external iliac artery anastomosis usually result in high rates of transplant nephrectomy. 3 There have been only a few reports [4][5][6][7] of true mycotic aneurysms of the renal allograft artery (Table 2). It is a result of faulty surgical technique, kinking of the renal artery, instrumental injury during perfusion, dissection of the vasa vasorum, and immunologic mechanisms.…”

Section: Discussionmentioning

confidence: 99%

"True" Mycotic Aneurysm of the Anastomotic Site of the Renal Allograft Artery

Ram²,

Swarnalatha³

et al. 2012

Exp Clin Transplant

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The incidence of vascular complications after renal transplant as reported varies from 3.5% to 14%. Pseudoaneurysm formation at the site of the anastomosis is a rare complication, and only a few cases have been reported. There also were only a few reports of "true" mycotic aneurysms of the renal allograft artery. We present 2 patients with true mycotic aneurysmal formation of the renal allograft artery after a renal transplant. Both patients presented with fever and increasing serum creatinine levels. Cultures from aneurysm tissue samples have grown Aspergillus flavus. Both patients were subjected to an allograft nephrectomy, and amphotericin was given.

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Section: Discussionmentioning

confidence: 99%

"True" Mycotic Aneurysm of the Anastomotic Site of the Renal Allograft Artery

Ram²,

Swarnalatha³

et al. 2012

Exp Clin Transplant

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“…While anastomotic pseudoaneurysms have been reported since 1985, 2 infectious pseudoaneurysms have been rarely reported and were often associated with graft loss in the case reports and series available in literature (Table 1). 3,4 They usually present with a wide spectrum of presentation, ranging from iliac fossa pain and fever to lower limb ischemia or even hemorrhagic shock due to rupture of pseudoaneurysm. Causes of infectious aneurysm formation are multifactorial.…”

Section: Discussionmentioning

confidence: 99%

Infectious anastomotic pseudoaneurysm complicating renal allograft: case report and review of literature

Chung¹,

Chan²,

Law³

et al. 2017

IJNRD

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Infectious anastomotic pseudoaneurysm complicating renal transplant is rare, but probably under-reported with <30 cases worldwide. We report a 45-year-old man with hypertension, diabetes mellitus and end stage renal failure, who had a renal transplant anastomosed to the right external iliac artery and vein. Postoperatively, he made a slow recovery with malaise and persistent vague right iliac fossa discomfort. Ultrasound scan 1 month postoperatively showed perinephric collection, and fluid culture grew Enterococcus faecium and Pseudomonas aeruginosa. He was started on vancomycin, daptomycin and colistin. MAG-3 scan also showed suboptimal function in the renal allograft. His symptoms persisted with fever, and blood culture yielded P. aeruginosa. Repeated ultrasound scan, and subsequent computed tomography scan a few weeks later, showed perinephric collection and a large, 3.8×3.5 cm pseudoaneurysm posteromedial to the graft kidney. He underwent emergency graft excision, together with resection of the pseudoaneurysm with in situ reversed great saphenous vein interposition graft, and made a good recovery on hemodialysis. The aneurysm wall grew P. aeruginosa, and he was put on imipenem and cilastatin (tienam), colistin, ciprofloxacin and daptomycin. To our knowledge, this is one of very few cases in the world's literature in which a P. aeruginosa infectious anastomotic pseudoaneurysm developed after a renal allograft.

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“…5,6 Extra iliac artery pseudo-aneurysm and rupture following renal transplantation and hip prosthesis have also been reported. 7,8 There is little data on pseudo-aneurysms of the pelvic vessels, particularly following major pelvic surgeries for cancer. The pseudo-aneurysms might develop in the early and late postoperative periods following radical pelvic surgery.…”

Section: Discussionmentioning

confidence: 99%

Delayed massive hemorrhage due to external iliac artery pseudo-aneurysm and uretero-iliac artery fistula following robotic radical cystectomy and intracorporeal Studer pouch reconstruction: endovascular management of an unusual complication

Atmaca

Canda

Gümüş

et al. 2013

CUAJ

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We report a very unusual complication of uretero-iliac artery fistula that developed following robotic radical cystectomy (RARC), bilateral extended pelvic lymph node dissection and intracorporeal Studer pouch reconstruction. Our patient was a 54-year-old male who was admitted 1 month after undergoing robotic surgery due to intermittently occurring massive transurethral bleeding necessitating blood transfusion that stopped by itself. Angiography showed a right external iliac artery pseudo-aneurysm and a fistula tract between the pseudo-aneurysm and Wallace type ureteral anostomosis that was successfully treated by an angiographic endovascular stent insertion at this level. Uretero-iliac artery fistula might occur following RARC, bilateral extended pelvic lymph node dissection and intracorporeal Studer pouch reconstruction leading to intermittently massive transurethral bleeding. Angiography and stenting are important for diagnosis and successful treatment of this rare entity.

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External iliac artery pseudoaneurysm complicating renal transplantation

Cited by 48 publications

References 20 publications

"True" Mycotic Aneurysm of the Anastomotic Site of the Renal Allograft Artery

"True" Mycotic Aneurysm of the Anastomotic Site of the Renal Allograft Artery

Infectious anastomotic pseudoaneurysm complicating renal allograft: case report and review of literature

Delayed massive hemorrhage due to external iliac artery pseudo-aneurysm and uretero-iliac artery fistula following robotic radical cystectomy and intracorporeal Studer pouch reconstruction: endovascular management of an unusual complication

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