Jornal Vascular Brasileiro
https://app.periodikos.com.br/journal/jvb/article/doi/10.1590/S1677-54492010000300012
Jornal Vascular Brasileiro
Case Report

Endovascular repair of an aorto-iliac aneurysm succeeded by kidney transplantation

Tratamento endovascular de aneurisma aorto-ilíaco sucedido por transplante renal

Marcelo Bellini Dalio; Matheus Bredarioli; Edwaldo Edner Joviliano; Jesualdo Cherri; Haylton Jorge Suaid; Carlos Eli Piccinato

http://dx.doi.org/10.1590/S1677-54492010000300012 J Vasc Bras, vol.9, n3, p.164-167, 2010
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Abstract

We present the case of aorto-iliac aneurysm in a patient with chronic renal failure requiring dialysis who were treated with an endovascular stent graft and, later on, submitted to kidney transplantation. A 53-year-old male with renal failure requiring dialysis presented with an asymptomatic abdominal aorto-iliac aneurysm measuring 5.0cm of diameter. He was treated with endovascular repair technique, being used an endoprosthesis Excluder®. After four months, he was successfully submitted to kidney transplantation (dead donor), with anastomosis of the graft renal artery in the external iliac artery distal to the endoprosthesis. The magnetic resonance imaging, carried out 30 days after the procedure, showed a good positioning of the endoprosthesis and adequate perfusion of the renal graft. In the follow-up, the patient presented improvement of nitrogenous waste, good positioning of the endoprosthesis without migration or endoleak. The endovascular repair of aorto-iliac aneurysm in a patient with end-stage renal failure under hemodialysis treatment showed to be feasible, safe and efficient, as it did not prevent the success of the posterior kidney transplantation.

Keywords

Aortic aneurysm, iliac aneurysm, blood vessel prosthesis, kidney transplantation

Resumo

Apresentamos o caso de aneurisma aortoilíaco em um paciente com insuficiência renal crônica dialítica tratado com uma endoprótese vascular, sendo, após, submetido a transplante renal. Um homem de 53 anos com insuficiência renal dialítica apresentava um aneurisma abdominal aortoilíaco assintomático com 5,0cm de diâmetro. Foi tratado com técnica endovascular com uma endoprótese Excluderâ. Após quatro meses, foi submetido a transplante renal (doador cadáver) com sucesso, com anastomose da artéria renal do enxerto na artéria ilíaca externa distal à endoprótese. A ressonância magnética 30 dias após o procedimento mostrou a endoprótese bem posicionada e o enxerto renal bem perfundido. No seguimento, o paciente evoluiu com melhora das escórias nitrogenadas, bom posicionamento da endoprótese, sem migração ou endoleak. O reparo endovascular do aneurisma aortoilíaco em paciente com insuficiência renal terminal em hemodiálise mostrou-se exequível, seguro e eficaz, e não comprometeu o sucesso do transplante renal posterior.

Palavras-chave

Aneurisma aórtico, aneurisma ilíaco, prótese vascular, transplante de rim

References

Bown MJ, Norwood MG, Sayers RD. The management of abdominal aortic aneurysms in patients with concurrent renal impairment. Eur J Vasc Endovasc Surg. 2005;30:1-11.

Pedron C, Palis ACM, von Ristow A. Endovascular treatment of abdominal aortic aneurysm in a patient with chronic renal failure. J Vasc Bras. 2006;5:325-30.

Brekke IB, Lien B, Sødal G. Aortoiliac reconstruction in preparation for renal transplantation. Transplant Int.. 1993;6:161-3.

Piquet P, Berland Y, Coulange C, Olmer M, Mercier C, Rampal M. Aortoiliac reconstruction and renal transplantation: staged or simultaneous. Ann Vasc Surg. 1989;3:251-6.

Gouny P, Lenot B, Decaix B. Aortoiliac surgery and kidney transplantation. Ann Vasc Surg. 1991;5:26-31.

Rutherford RB, Krupski WC. Current status of open versus endovascular stent-graft repair of abdominal aortic aneurysm. J Vasc Surg. 2004;39:1129-39.

Moon IS, Park SC, Kim SN. Abdominal aortic aneurysm repair in kidney transplant recipients. Transplant Proc.. 2006;38:2022-4.

Forbes TL, DeRose G, Kribs S, Abraham CZ, Harris KA. Endovascular repair of abdominal aortic aneurysm with coexisting renal allograft: Case report and literature review. Ann Vasc Surg. 2001;15:586-90.

Lacombe M. Surgical treatment of aortoiliac aneurysms in renal transplant patients. J Vasc Surg. 2008;48:291-5.

Shrestha BM, McKane WS, Raftery AT. Renal transplantation after endovascular repair of abdominal aortic aneurysm. Transplant Proc. 2007;39:1670-2.

George P, Tan HP, Beebe H, Ratner LE. Successful renal transplantation after endovascular bifurcated stent graft repair of an abdominal aortic aneurysm. Transplantation. 2001;72:533-4.

Adamec M, Matia I, Janousek L. Renal transplantation in patients with abdominal aortic aneurysm-a new surgical approach. Transpl Int. 2004;17:647-50.

Unno N, Inuzuka K, Yamamoto N, Sagara D, Suzuki M, Konno H. Preservation of pelvic circulation with hypogastric artery bypass in endovascular repair of abdominal aortic aneurysm with bilateral iliac artery aneurysms. J Vasc Surg. 2006;44:1170-5.

Bergamini TM, Rachel ES, Kinney EV, Jung MT, Kaebnick HW, Mitchell RA. External iliac artery-to-internal iliac artery endograft: A novel approach to preserve pelvic inflow in aortoiliac stent grafting. J Vasc Surg. 2002;35:120-4.

Zander T, Baldi S, Rabellino M, Rostagno R, Isaza B, Llorens R. Bilateral hypogastric artery occlusion in endovascular repair of abdominal aortic aneurysms and its clinical significance. J Vasc Interv Radiol. 2007;18:1481-6.

Haulon S, Greenberg RK, Pfaff K, Francis C, Koussa M, West K. Branched grafting for aortoiliac aneurysms. Eur J Vasc Endovasc Surg. 2007;33:567-74.

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