Transplant Renal Artery Stenosis Revascularization: Common Distal External Iliac Bypass
| Autor: | Christopher Chiodo Ortiz, Santiago J. Miyara, Kambhampaty Krishnasastry, Kei Hayashida, Jorge Molinas, Koichiro Shinozaki, Young Min Cho, Alexia Molmenti, Joaquin Cagliani, Lance B Becker, Ryosuke Takegawa, Ernesto P. Molmenti, Sara Guevara, Gerardo Tamayo-Enriquez |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2020 |
| Předmět: |
medicine.medical_specialty
Kidney business.industry medicine.medical_treatment External iliac artery 030230 surgery Anastomosis Renal hilum Revascularization medicine.disease Common iliac artery Surgery 03 medical and health sciences Stenosis 0302 clinical medicine medicine.anatomical_structure medicine.artery Medicine 030211 gastroenterology & hepatology Renal artery Cardiology and Cardiovascular Medicine business |
| Zdroj: | Int J Angiol |
| Popis: | Stenosis proximal to transplant renal artery anastomoses are complications leading to allograft dysfunction. This study was aimed to evaluate a novel surgical approach to renal allograft revascularization, taking into consideration the length of time elapsed since transplantation. We describe an arterial bypass using a polytetrafluoroethylene (PTFE) graft from the common iliac artery (proximal to the renal artery implantation) to the external iliac artery (distal to the renal artery implantation) that allows the adequate revascularization of both the transplant kidney, as well as the lower extremity. This technique provides several advantages when compared with previously described procedures to revascularize a transplanted kidney with an iliac artery stenosis proximal to the allograft implantation site. Benefits of this technique include (1) no need to repair the stenosis, (2) no need to take down and redo the arterial anastomosis, (3) no need to perform a dissection around the renal hilum of the transplanted kidney, (4) no requirement to address the anastomosis transfer, and (5) no need to perfuse the kidney with preservation fluid at the time of repair and/or (6) avoidance of potential injury to the renal parenchyma and/or hilum during dissections. Adequate perfusion of the organ, as well as of the lower extremity was verified by serial Doppler duplex ultrasound evaluations. Hence, we describe a novel revascularization technique in instances of kidney transplant and lower extremity ischemia. |
| Databáze: | OpenAIRE |
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