Maritati Federica, Pini Rodolfo, Comai Giorgia, Bini Claudia, Corradetti Valeria, Mattiotti Maria, Ravaioli Matteo, Pini Alessia, La Manna Gaetano, Gargiulo Mauro
Nephrology, Dialysis and Renal Transplant Unit, IRCCS-Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy.
Vascular Surgery Unit, IRCCS-Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy.
J Endovasc Ther. 2024 Feb;31(1):140-145. doi: 10.1177/15266028221107882. Epub 2022 Jul 2.
Anastomotic pseudoaneurysms of transplanted kidneys are a very rare complication encountered in less than 1% of cases. They may be devastating, leading to functional impairment, kidney transplantectomy, or death. Treatment has not been standardized, with open surgical repair considered the safest procedure even if it is often complicated by bleeding and graft loss. The purpose of this case report is to describe an endovascular treatment of this condition, consisting of the combination of coil embolization and arterial stenting.
A 61-year-old woman developed an anastomotic pseudoaneurysm 2 months after kidney transplantation, causing acute kidney injury related to ab-extrinsic stenosis of the transplant renal artery (TRA) and external iliac artery. The pseudoaneurysm was successfully treated by coil embolization, and the arterial patency was restored by the stenting of TRA and external iliac artery. The patient completely recovered kidney function, and after a 6-month-follow-up, creatinine values were stable with normal renal perfusion.
Endovascular repair through coil embolization and TRA stenting can be a safe and effective option to treat anastomotic pseudoaneurysm in kidney transplant.
移植肾吻合口假性动脉瘤是一种非常罕见的并发症，发生率不到1%。它们可能具有破坏性，导致功能损害、肾移植切除术或死亡。治疗方法尚未标准化，开放手术修复被认为是最安全的手术，即使它常常伴有出血和移植物丢失等并发症。本病例报告的目的是描述这种疾病的血管内治疗方法，即弹簧圈栓塞和动脉支架置入术相结合。
一名61岁女性在肾移植术后2个月出现吻合口假性动脉瘤，导致与移植肾动脉（TRA）和髂外动脉外源性狭窄相关的急性肾损伤。通过弹簧圈栓塞成功治疗了假性动脉瘤，并通过TRA和髂外动脉支架置入恢复了动脉通畅。患者肾功能完全恢复，经过6个月的随访，肌酐值稳定，肾灌注正常。
通过弹簧圈栓塞和TRA支架置入进行血管内修复可以是治疗肾移植吻合口假性动脉瘤的一种安全有效的选择。
