Repair of complex renal artery aneurysms by laparoscopic nephrectomy with ex vivo repair and autotransplantation

Abstract

Repair of complex renal artery aneurysms involving distal branch arteries remains a challenge. This new technique combines the advantages of minimally invasive surgery with the effectiveness of ex vivo aneurysm repair.

Bilateral ex vivo repair and kidney autotransplantation for complex renal artery aneurysms: A case report and literature review

“…In their series of seven complex RAA treated by ex vivo repair and autotransplantation, Gallagher et al showed stable renal function postoperatively in all patients. 8 In another study on seven patients Shirodkar et al reported no intraoperative complications and only one case with renal function loss. 9 Recently, Morin et al have described a series of nine patients who underwent ex vivo repair and autotransplantation on solitary kidneys with no detrimental effect on renal function.…”

Experiences of Renal Transplants From Donors With a Renal Artery Aneurysm After a Laparoscopic Donor Nephrectomy and Ex Vivo Reconstruction of the Renal Artery

“…3 Recently, autotransplant after resection of the aneurysm and ex vivo reconstruction of the renal artery have been reported as treatment options with acceptable results. [4][5][6][7] Considering the long operative time from its sequential nature and the potential morbidity it presents, the procedure might be excessive, especially for older patients. In this respect, a kidney transplant to any willing recipient Kidney transplant is the optimal treatment for select patients with end-stage renal disease.…”

“…3 Autotransplant, which is performed after nephrectomy, followed by resection of the aneurysm and ex vivo reconstruction of the renal artery, has been reported rarely as a treatment option for patients who require nephrectomy. [4][5][6][7] However, in the era of donor shortages, a kidney transplant to any willing recipient is a treatment option for patients with RAA. We report 2 cases of a renal transplant from donors with RAA, in which hand-assisted laparoscopic nephrectomy, followed by resection of the aneurysm and ex vivo renal artery reconstruction were performed.…”

Renal artery aneurysm: An endovascular treatment for a rare cause of hypertension

“…5 Other causes for such interventions are symptomatic aneurysms (flank pain, hypertension, hematuria), rapidly expanding aneurysms and those larger than 2 cm. 6 The choice of treatment of RAAs is determined by the anatomic location of the aneurysm. 5 Although stent grafts and stent-plus-coil embolization techniques are successful for most simple RAAs, 7 complex aneurysms beyond the bifurcation of the main renal artery, or those involving major arterial branches, may require extracorporal arterial reconstruction followed by autotransplantation.…”

“…5 Although stent grafts and stent-plus-coil embolization techniques are successful for most simple RAAs, 7 complex aneurysms beyond the bifurcation of the main renal artery, or those involving major arterial branches, may require extracorporal arterial reconstruction followed by autotransplantation. 6 …”