Fenestrated Endograft as a New Perspective for the Treatment of Infrarenal Abdominal Aortic Aneurysm with a Congenital Pelvic Kidney—A Case Report and Review of Literature

We report a case of a man with an Aorto-Iliac aneurysm and a congenital solitary pelvic kidney (CSPK). The maximum diameter of the aneurysm was 58 mm and the pelvic kidney was perfused by a single renal artery originating from the aortic bifurcation. A computed tomography scan was used for pre-operative planning and the patient underwent aorto-iliac aneurysm replacement with a Dacron graft. The renal artery was reimplanted on the Dacron right limb with a ‘Carrel patch’. Several strategies were adopted to prevent renal ischemia such as sequential aortic cross clamping, selective cold perfusion of renal artery and a temporary Pruitt–Inahara shunt. The post-operative course was characterized by a transient increase in serum creatinine that did not require treatments and the patient was discharged after seven days. Congenital anomalies such as CSPK represent a challenge for the surgeon; however, the adoption of different intraoperative available strategies allowed to reduce possible complications.

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“…Majumder et al. also reported a case of abdominal aortic aneurysm treated with a fenestrated custom-made endoprosthesis [ 4 ].…”

Section: Discussionmentioning

confidence: 99%

Surgical therapy of aorto-iliac aneurysm in a patient with congenital solitary pelvic kidney (CSPK): case report and literature review

Capone

Fargion

Esposito

et al. 2023

Journal of Surgical Case Reports

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“…The absence of any of these contraindicates the endovascular approach, and thus hybrid management strategies have been proposed to provide less invasive options than open repair 6,7 . These strategies include the use of a monoiliac prosthesis with iliac occlusion devices and subsequent femoral bypass or open reimplantation of the ectopic renal artery for subsequent EVAR 6,7 .…”

Section: Discussionmentioning

confidence: 99%

Cold nephroprotection for repair of aortic ectasia and bilateral iliac aneurysms in the presence of pelvic ectopic kidney

Gómez-Galán¹,

Polanía-Sandoval²,

Rodríguez-González³

et al. 2023

RCCARE

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Solitary pelvic ectopic kidneys associated with aneurysmal degeneration of the iliac arteries and abdominal aorta are very rare events. Surgical approaches for the correction of aneurysms with renal involvement are challenging due to the lack of current consensus, especially when they are associated with functional solitary pelvic ectopic kidneys. For this reason, one of the strategies that has shown good results in the short-and medium-term is cold nephroprotection, which can be used safely in these patients. In the present case, aortic ectasia with bilateral iliac aneurysms associated with a solitary pelvic ectopic kidney was evidenced in a 75-year-old male patient with arterial hypertension and dyslipidemia. Bilateral aortoiliac reconstruction was performed with hypogastric artery reconstruction and reimplantation of the ectopic renal artery under cold renal irrigation, without complications and with preserved renal function.

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“…A chimney or branched/fenestrated graft approach was not chosen due to the small size of the proximal renal artery and the long length required. 6 9 …”

Section: Discussionmentioning

confidence: 99%

Endovascular Repair of an Inflammatory Abdominal Aortic Aneurysm Combined with a Congenital Pelvic Kidney: Case Report and Literature Review

et al. 2022

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The coexistence of an abdominal aortic aneurysm and a congenital pelvic kidney is extremely rare. We present a 66-year-old male with an inflammatory aneurysm and an aberrant origin of the superior mesenteric artery. The inflammatory infrarenal abdominal aortic aneurysm with a congenital left pelvic kidney was successfully treated with endovascular repair. Coverage of one out of the two renal ectopic arteries was performed, without clinical evidence of renal function impairment.

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Fenestrated Endograft as a New Perspective for the Treatment of Infrarenal Abdominal Aortic Aneurysm with a Congenital Pelvic Kidney—A Case Report and Review of Literature

Cited by 8 publications

References 9 publications

Surgical therapy of aorto-iliac aneurysm in a patient with congenital solitary pelvic kidney (CSPK): case report and literature review

Surgical therapy of aorto-iliac aneurysm in a patient with congenital solitary pelvic kidney (CSPK): case report and literature review

Cold nephroprotection for repair of aortic ectasia and bilateral iliac aneurysms in the presence of pelvic ectopic kidney

Endovascular Repair of an Inflammatory Abdominal Aortic Aneurysm Combined with a Congenital Pelvic Kidney: Case Report and Literature Review

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