Malinowski Michael J, Al-Nouri Omar, Hershberger Richard, Halandras Pegge M, Aulivola Bernadette, Cho Jae S
Division of Vascular Surgery, Medical College of Wisconsin, Milwaukee, WI.
Division of Vascular Surgery and Endovascular Therapy, Loyola University Chicago, Stritch School of Medicine, Maywood, IL.
Ann Vasc Surg. 2014 Aug;28(6):1566.e7-10. doi: 10.1016/j.avsg.2014.01.015. Epub 2014 Feb 8.
Renal ectopia in the rare condition of associated abdominal aortic aneurysm presents a difficult clinical challenge with respect to access to the aorto-iliac segment and preservation of renal function because of its anomalous renal arterial anatomy and inevitable renal ischemia at the time of open repair. Multiple operative techniques are described throughout the literature to cope with both problems. We report a case of a 57-year-old male with an aorto-iliac aneurysm and a congenital solitary pelvic kidney successfully treated by hybrid total renal revascularization using iliorenal bypass followed by unilateral internal iliac artery coil embolization and conventional endovascular aortic aneurysm repair without any clinical evidence of renal impairment.
肾异位合并腹主动脉瘤这种罕见情况，由于其异常的肾动脉解剖结构以及开放修复时不可避免的肾缺血，在进入腹主动脉-髂动脉段和保护肾功能方面带来了严峻的临床挑战。文献中描述了多种手术技术来应对这两个问题。我们报告一例57岁男性患者，患有腹主动脉-髂动脉瘤和先天性孤立盆腔肾，通过采用髂肾旁路进行混合性全肾血管重建、随后进行单侧髂内动脉弹簧圈栓塞以及传统的血管腔内腹主动脉瘤修复，成功治愈，且无任何肾功能损害的临床证据。
