title: Ex vivo repair and renal autotransplantation for complex renal artery aneurysms in a solitary kidney.
abstract: Renal artery aneurysm (RAA) is a rare clinical entity with an incidence of 0.015-1%. Indications for interventional or surgical repair of RAAs are expanding aneurysms, diameter >2.5 cm, intractable renovascular hypertension, dissecting RAA, hematuria, and renal infarction after distal embolization. Interventional insertion of a stent graft as well as aortorenal bypass implantation are both low-risk procedures in simple aneurysms of the proximal renal artery. However, complex distal renal aneurysms involving several renal artery branches require not only an excellent result of vascular reconstruction, but also a surgical technique offering maximal protection for the kidney during the ischemic period. Here, we present a case of a solitary kidney with two consecutive RAAs of segmental renal artery branches (type 2 RAA). A surgical strategy including renal explantation, ex vivo renal preservation, ex vivo reconstruction of the renal artery, and renal heterotopic autotransplantation was successfully applied. The technique of ex vivo repair is a safe and effective surgical procedure in this clinical setting.
authors.affiliation: Division of Thoracic and Cardiovascular Surgery, Hannover Medical School, Carl-Neuberg-Str. 1, 30625 Hannover, Germany. kknobi@yahoo.com
authors.forename: Karsten
authors.initials: K
authors.lastname: Knobloch
authors.forename: Karsten
authors.initials: K
authors.lastname: Wiebe
authors.forename: Artur
authors.initials: A
authors.lastname: Lichtenberg
authors.forename: Stefan
authors.initials: S
authors.lastname: Fischer
authors.forename: Bernhard
authors.initials: B
authors.lastname: Gohrbandt
authors.forename: Axel
authors.initials: A
authors.lastname: Haverich
mesh_terms: D000783:Aneurysm / Q000000981:diagnostic imaging / Q000601:surgery*; D005260:Female; D006801:Humans; D007668:Kidney / Q000002:abnormalities*; D008875:Middle Aged; D009392:Nephrectomy; D011859:Radiography; D012077:Renal Artery / Q000000981:diagnostic imaging / Q000601:surgery; D014182:Transplantation, Autologous