Ruptured Complex Aortoiliac Aneurysm in an Elderly Patient With a Kidney Transplant Presenting With Sciatica.

Autor:	Kostiuk V; Yale University School of Medicine, New Haven, CT, USA., Rodriguez PP; Division of Vascular Surgery and Endovascular Therapy, Department of Surgery, Yale University School of Medicine, New Haven, CT, USA., Aboian E; Division of Vascular Surgery and Endovascular Therapy, Department of Surgery, Yale University School of Medicine, New Haven, CT, USA., Kuwayama DP; Division of Vascular Surgery and Endovascular Therapy, Department of Surgery, Yale University School of Medicine, New Haven, CT, USA., Guzman RJ; Division of Vascular Surgery and Endovascular Therapy, Department of Surgery, Yale University School of Medicine, New Haven, CT, USA., Ochoa Chaar CI; Division of Vascular Surgery and Endovascular Therapy, Department of Surgery, Yale University School of Medicine, New Haven, CT, USA.
Jazyk:	angličtina
Zdroj:	Vascular and endovascular surgery [Vasc Endovascular Surg] 2024 Oct 22, pp. 15385744241296220. Date of Electronic Publication: 2024 Oct 22.
DOI:	10.1177/15385744241296220
Abstrakt:	Background: Common iliac artery aneurysms are uncommon, with an estimated incidence of less than 0.01% in adults and accounting for only 1% of all intra-abdominal aneurysms. While the risk of rupture is approximately 5%, it increases significantly to 29% once the aneurysm reaches 4 cm. Similarly to abdominal aortic aneurysms, common iliac artery aneurysms often develop silently, remaining asymptomatic in about 70% of cases. This report describes the treatment of a patient with a kidney transplant who underwent endovascular repair of a ruptured left common iliac artery aneurysm with a concomitant abdominal aortic aneurysm and a focal aneurysm of the right renal artery origin. Case Description: A 78-year-old male patient with a kidney transplant presented with left sciatica symptoms and was found to have a contained rupture of a 10 x 7 cm left common iliac artery aneurysm with a concomitant 8 cm abdominal aortic aneurysm and a focal 1.8 cm aneurysm of the right renal artery origin. He underwent an endovascular aneurysm repair with an Aorto-Uni-iliac stent graft and a concomitant right-to-left femoral-femoral bypass using 8 mm ringed PTFE graft and ligation of left external iliac artery to prevent retrograde flow into the left common iliac artery aneurysm. At 3-year follow-up, patient remains stable with a functioning kidney transplant and excluded aneurysms with no evidence of endoleak. Conclusion: This report describes the endovascular repair of a ruptured left common iliac artery aneurysm conducted under local anesthesia in a patient with a renal transplant and complex aneurysm anatomy. The calcification pattern observed on a non-contrast CT scan was effectively used for surgical planning, leading to a successful aneurysm repair while preserving kidney transplant function. Competing Interests: Declaration of conflicting interestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
Databáze:	MEDLINE
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