Management of bilateral renal artery aneurysms with laparoscopic nephrectomy, ex vivo reconstruction, and autotransplantation in a woman planning pregnancy

Abstract

Renal artery aneurysms (RAAs) are rare, with an estimated incidence of 0.01% to 0.97%. These aneurysms are often asymptomatic, although they occasionally manifest with hypertension, back pain, hematuria, or rupture. Despite limited evidence guiding treatment, women of childbearing age are consistently offered treatment because of the high risk of rupture. We present a case of a woman planning pregnancy with bilateral RAAs after failed endovascular management. She underwent bilateral laparoscopic nephrectomy, ex vivo reconstruction, and autotransplantation for treatment of her aneurysms. This appears to be safe and effective for treatment of RAAs and should be considered in similar patients. (J Vasc Surg Cases and Innovative Techniques 2020;6:126-8.)

Laparoscopic nephrectomy, ex vivo renal artery aneurysm repair, and autotransplantation for symptomatic aneurysm with thromboembolism

“…One study noted an increased risk of renal infarction with endovascular management (22%) compared with open reconstruction (5%). 7 Open surgical repair is more common for RAAs with more efferent branches. 4 …”

3D-Printed Cold Preservation Device in Renal Autotransplantation for the Treatment of a Patient With Renal Artery Stenosis

“…In most studies, the use of laparoscopy is limited and mostly applied for nephrectomy ( Hiess and Seitz, 2016 ; Siena et al, 2019 ; Kishore et al, 2020 ). After nephrectomy, renal vessels are extracted from the abdominal cavity and transferred to the bench table, and a separate incision is required to anastomose the renal vessels with the iliac vessels ( Kubota et al, 2020 ; Pomy et al, 2020 ; Smith et al, 2020 ). Although some studies have reported intracorporeal robot-assisted renal autotransplantation and restrictions due to kidney cold preservation in vivo , the kidney is not cold preserved continuously during the operation after vessel dissociation ( Breda et al, 2021 ).…”