Ex vivo revascularization of renal artery aneurysms in a patient with solitary kidney: A case report  

作　　者：Xi-Yang Chen Ji-Chun Zhao Bin Huang Ding Yuan Yi Yang 

机构地区：[1]Department of Vascular Surgery,West China Hospital of Sichuan University

出　　处：《World Journal of Clinical Cases》2019年第16期2401-2405,共5页世界临床病例杂志

摘　　要：BACKGROUND Multiple renal artery aneurysms (RAAs) involving multiple branches in a solitary kidney are rare and present a major challenge to surgeons.Ex vivo or in situ repair combined with renal artery revascularization is the classical procedure for these complicated cases,which are not suitable for endovascular repair.The choice of bypass graft remains controversial because of the risk of aneurysmal degeneration for autologous graft.CASE SUMMARY A 39-year-old female patient presented with left lumbar pain for more than 3 mo.Computed tomography angiography showed congenital absence of the right kidney and three left RAAs involving multiple distal branches.This patient met the criteria for surgical repair due to symptoms of threatened rupture.According to the anatomy and location of multiple RAAs,ex vivo revascularization with saphenous vein graft (SVG) was performed.At the 3-year follow-up,computed tomography angiography demonstrated the aneurysmal degeneration of the Yshaped SVG.The patient remained asymptomatic and follow-up ultrasound showed no continuous growth of SVG aneurysm.CONCLUSION SVG aneurysm in RAA revascularization causes us to reflect on the choice of graft,especially for solitary kidney patients.BACKGROUND Multiple renal artery aneurysms(RAAs) involving multiple branches in a solitary kidney are rare and present a major challenge to surgeons. Ex vivo or in situ repair combined with renal artery revascularization is the classical procedure for these complicated cases, which are not suitable for endovascular repair. The choice of bypass graft remains controversial because of the risk of aneurysmal degeneration for autologous graft.CASE SUMMARY A 39-year-old female patient presented with left lumbar pain for more than 3 mo.Computed tomography angiography showed congenital absence of the right kidney and three left RAAs involving multiple distal branches. This patient met the criteria for surgical repair due to symptoms of threatened rupture. According to the anatomy and location of multiple RAAs, ex vivo revascularization with saphenous vein graft(SVG) was performed. At the 3-year follow-up, computed tomography angiography demonstrated the aneurysmal degeneration of the Yshaped SVG. The patient remained asymptomatic and follow-up ultrasound showed no continuous growth of SVG aneurysm.CONCLUSION SVG aneurysm in RAA revascularization causes us to reflect on the choice of graft, especially for solitary kidney patients.

关 键 词：RENAL artery ANEURYSM BYPASS Ex vivo repair ANEURYSMAL DEGENERATION Case report 

分 类 号：R[医药卫生]