Modification of a bifurcated stent graft for aortouniiliac endovascular aneurysm repair in a renal transplant patient.
BACKGROUND
We describe a case of aortouniiliac (AUI) endovascular aortic aneurysm repair (EVAR) using combined iliac limb and bifurcated body stent graft modular system.


METHODS
This technique is demonstrated in a 58-year-old man with a 6-cm abdominal aortic aneurysm suitable for EVAR. The patient has a functioning cadaveric renal transplant anastamosed to the mid right external iliac artery, an occluded left iliac system and stenosed right iliac system. The renal allograft was protected with minimal passage across the transplant artery origin using this modified approach. The patient was successfully treated with a bifurcated main body deployed within a contralateral limb endoprosthesis. Subsequent scans confirmed no endoleaks or stent migration.


CONCLUSIONS
The AUI conversion from existing Gore excluder stent graft system is safe and should be considered when faced with challenging anatomy of a pelvic renal transplant, slender access, and contralateral iliac occlusion.
Department of Vascular Surgery, Queen Elizabeth Hospital, Birmingham, UK.
Henrietta
H
Poon
Martin J
MJ
Duddy
Alok
A
Tiwari
Jonathan D
JD
Hopkins
D015901:Angiography, Digital Subtraction; D017544:Aortic Aneurysm, Abdominal / Q000000981:diagnostic imaging / Q000601:surgery*; D001027:Aortography / Q000379:methods; D001807:Blood Vessel Prosthesis; D019917:Blood Vessel Prosthesis Implantation / Q000295:instrumentation*; D057510:Endovascular Procedures / Q000295:instrumentation*; D006801:Humans; D007083:Iliac Artery / Q000000981:diagnostic imaging / Q000601:surgery*; D016030:Kidney Transplantation; D008297:Male; D008875:Middle Aged; D011474:Prosthesis Design; D015607:Stents; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome