Bedfordshire Vascular Unit, Bedford General Hospital, Bedford MK42 9DJ, United Kingdom.
Eur J Vasc Endovasc Surg. 2011 May;41(5):654-6. doi: 10.1016/j.ejvs.2011.02.011. Epub 2011 Feb 25.
Aberrant renovascular anatomy due to a horseshoe kidney becomes challenging during endovascular aneurysm repair.
A 65-year-old man presented with a horseshoe kidney overlying a 6.1 cm abdominal aortic aneurysm, with the inferior vena cava anterior to both aneurysm and kidney. The left renal artery shared a common origin with the inferior mesenteric artery. Management was by endovascular repair with precannulation of the common left renal/inferior mesenteric arterial origin as a strategic marker, allowing deployment of a standard bifurcated stent-graft.
Innovative endovascular/fenestrated/sidebranching techniques make issues of aberrant anatomy redundant and reduces surgical morbidity; with relatively simple anatomy precannulation of aberrant vessel(s) guides deployment of the top end of a standard stent-graft.
马蹄肾导致的异常血管解剖结构在血管内动脉瘤修复中极具挑战性。
一名 65 岁男性，其马蹄肾覆盖于 6.1cm 腹主动脉瘤上方，下腔静脉位于动脉瘤和肾脏前方。左肾动脉与肠系膜下动脉共干。采用血管内修复，在左肾/肠系膜下动脉共干的预插管作为策略性标记，以允许部署标准分叉支架移植物。
创新性的血管内/开窗/分支技术使异常解剖结构的问题变得多余，并降低了手术发病率；对于相对简单的解剖结构，异常血管的预插管可指导标准支架移植物顶端的部署。
