EVAR Approach for Abdominal Aortic Aneurysm with Horseshoe Kidney: A Multicenter Experience

Autor: Mauricio Gonzalez-Urquijo, Serguey Varona Frolov, Carlos Vaquero Puerta, Vicente Riambau, Mario Alejandro Fabiani, Nilo J. Mosquera Arochena, Thomas S. Maldonado
Rok vydání: 2018
Předmět:
Male
medicine.medical_specialty
Time Factors
Computed Tomography Angiography
030204 cardiovascular system & hematology
Prosthesis Design
Aortography
030218 nuclear medicine & medical imaging
03 medical and health sciences
Aortic aneurysm
Blood Vessel Prosthesis Implantation
0302 clinical medicine
Aneurysm
Blood vessel prosthesis
Risk Factors
medicine
Humans
cardiovascular diseases
Myocardial infarction
Fused Kidney
Computed tomography angiography
Aged
Retrospective Studies
Aged
80 and over
medicine.diagnostic_test
business.industry
Endovascular Procedures
Horseshoe kidney
General Medicine
Middle Aged
medicine.disease
Abdominal aortic aneurysm
Surgery
Blood Vessel Prosthesis
Treatment Outcome
cardiovascular system
Female
Stents
Cardiology and Cardiovascular Medicine
business
Abdominal surgery
Aortic Aneurysm
Abdominal
Zdroj: Annals of vascular surgery. 58
ISSN: 1615-5947
Popis: Background Horseshoe kidney is a congenital abnormality, with an incidence of 0.25% of the total population. Only 0.12% of patients who undergo an abdominal aortic aneurysm repair might also have a coexisting horseshoe kidney. We present a series of 10 cases auspiciously treated with an endovascular approach along with their respective patient evolutions. A review of the literature is also presented. Materials and Methods A retrospective review of the medical records (January 2004–December 2013) of 10 patients with abdominal aortic aneurysms and horseshoe kidney treated with endovascular repair was done. Patients were treated at 6 different centers in 3 different countries. Demographics, clinical status, medical history, anatomical morphology of the aneurysms and kidneys, as well as surgical outcomes were all analyzed. Results The median age was 67.5 years (range 47–81), and the median aortic aneurysmal diameter was 57 mm (49–81 mm). A total of 35 arteries provided renal perfusion. There were 13 right renal arteries and 13 left renal arteries, all successfully preserved, with 9 isthmus arteries covered. Median hospital stay consisted of 3.5 days (1–14 days). All aortic aneurysms were successfully excluded with no endoleaks, hematomas, wound infections, or renal failure. During a median follow-up of 7 years, 3 patients died of myocardial infarction 7 years after endovascular aortic repair (EVAR), and the other 7 patients are doing well, with a median aneurysm reduction size sac of 16.5 mm. Conclusions Endovascular repair is a safe and efficient endovascular option for the treatment of patients presenting concomitant aortic aneurysm and horseshoe kidney, with excellent short- and medium-term outcomes. To our knowledge, our study represents the largest series of cases with horseshoe kidney successfully treated via EVAR without significant complications.
Databáze: OpenAIRE
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