Majumder Barun, Perera Anisha H, Browning Neil, MacGregor Mark, Chapman Alex
Department of Vascular Surgery, Ashford and St. Peter's NHS Foundation Trust, Chertsey, UK.
Department of Vascular Surgery, Ashford and St. Peter's NHS Foundation Trust, Chertsey, UK.
Ann Vasc Surg. 2017 Nov;45:266.e1-266.e4. doi: 10.1016/j.avsg.2017.06.138. Epub 2017 Jul 14.
The coexistence of abdominal aortic aneurysm (AAA) and congenital pelvic kidney is infrequent. Various treatment modalities have been reported in literature for the treatment of the aforementioned condition. We report a complete endovascular modality for the treatment of this association, especially for high-risk patients. Only one such treatment has been reported before. Compared with this previously reported case, we would like to share our experience with additional prototype testing, before surgery, which provided us with more detailed information about the planning and deployment of the branched endograft. An incidental 7-cm infra renal AAA with the presence of right pelvic kidney was detected on magnetic resonance imaging performed for back pain in a 75-year-old male patient with a history of 2 previous myocardial infarctions and a radical prostatectomy for prostate cancer. He was unfit for open surgery. We report a custom-made fenestrated endograft with prior prototype information used for the repair of a large aneurysm with right pelvic kidney. This procedure is less invasive than any other reported treatment modalities such as open surgery or hybrid procedures. This procedure has an added advantage in that there is no renal ischemia, and recovery is significantly faster.
腹主动脉瘤（AAA）与先天性盆腔肾并存的情况并不常见。文献中已报道了多种治疗上述病症的方法。我们报告一种完全血管内治疗方法，用于治疗这种联合病症，特别是针对高危患者。此前仅报道过一例此类治疗。与之前报道的病例相比，我们希望分享在手术前进行额外原型测试的经验，这为我们提供了有关分支血管内移植物规划和部署的更详细信息。一名75岁男性患者因背痛进行磁共振成像检查时偶然发现了一个7厘米的肾下AAA，同时存在右盆腔肾，该患者有2次心肌梗死病史且因前列腺癌接受过根治性前列腺切除术。他不适合进行开放手术。我们报告了一种定制的开窗血管内移植物，使用了先前的原型信息来修复伴有右盆腔肾的大动脉瘤。该手术比其他任何报道的治疗方法（如开放手术或杂交手术）侵入性更小。此手术还有一个额外优势，即不存在肾缺血，恢复明显更快。
