Ruptured AAA in a patient with a horseshoe kidney: emergent treatment using the talent acute endovascular aneurysm repair kit.
OBJECTIVE
To report emergent endovascular repair of a ruptured abdominal aortic aneurysm (AAA) in a patient with a horseshoe kidney.


METHODS
A 78-year-old man with a horseshoe kidney presented with a contained rupture of a 72-mm AAA. After urgent computed tomographic angiography (CTA) documented the blood supply to the kidney and the suitability of the aneurysm for endovascular repair, the patient was given a local anesthetic. An aortomonoiliac stent-graft constructed from components provided in a Talent Acute Endovascular Aneurysm Repair Kit was inserted successfully. The procedure was completed with placement of a contralateral common iliac artery occluder and a femorofemoral bypass graft. No complications were encountered, and the patient was discharged with an excluded aneurysm on the fourth postoperative day. At 3 months, aneurysm exclusion was confirmed by CTA, and no endoleak was present; the retroperitoneal hematoma had disappeared. The patient remains in good general condition 8 months after treatment.


CONCLUSIONS
The advantages of endovascular aneurysm repair in the emergency setting can facilitate rapid recovery in patients with symptomatic or ruptured aneurysms, especially those having a horseshoe kidney.
Teijink
Joep A W
JA
Department of Surgery, Atrium Medical Center Heerlen, The Netherlands. j.teijink@atriummc.nl
Odink
Henk F
HF
Bendermacher
Bianca
B
Welten
Rob J T J
RJ
Veldhuijzen van Zanten
G Otto
GO
D000368:Aged; D017130:Angioplasty / Q000379:methods*; D017544:Aortic Aneurysm, Abdominal / Q000601:surgery*; D001019:Aortic Rupture / Q000601:surgery*; D019917:Blood Vessel Prosthesis Implantation / Q000379:methods*; D004638:Emergency Treatment / Q000379:methods*; D006801:Humans; D007668:Kidney / Q000002:abnormalities*; D008297:Male