Treatment of venous aortorenal bypass graft aneurysm using a stent-graft

Cardiovasc Intervent Radiol. 2010 Feb;33(1):177-81. doi: 10.1007/s00270-009-9579-6. Epub 2009 May 15.

Abstract

We present the case of a 77-year-old male patient who had undergone a bilateral venous aortorenal bypass graft 30 years previously. Thirteen years previously, the patient was shown to have a decrease in renal function, with mild shrinking of both kidneys; additionally, a stenosis was found in the left proximal anastomosis. At the most recent follow-up visit (1 year previously), ultrasound revealed an aneurysm (42 mm in diameter) of the left renal bypass graft; the finding was confirmed by CT angiography. A significant ostial stenosis of the left renal bypass graft was also confirmed. It was decided to place a self-expandable stent-graft into the aneurysm while also attempting to dilate the stenosis. Proximal endoleak after stent-graft placement necessitated the implantation of another, balloon-expandable stent-graft into the bypass graft ostium. Postprocedural angiography and follow-up by CT angiography at 3 months confirmed good patency of the stent-grafts and complete thrombosis of the aneurysmal sac, with preserved kidney perfusion. Renal function remained unaltered, while the hypertension is better controlled.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Aneurysm / diagnostic imaging
  • Aneurysm / etiology
  • Aneurysm / therapy*
  • Angiography
  • Blood Vessel Prosthesis*
  • Graft Occlusion, Vascular / diagnostic imaging
  • Graft Occlusion, Vascular / etiology
  • Graft Occlusion, Vascular / therapy*
  • Humans
  • Male
  • Middle Aged
  • Renal Artery Obstruction / diagnostic imaging
  • Renal Artery Obstruction / etiology
  • Renal Artery Obstruction / therapy*
  • Stents*
  • Tomography, X-Ray Computed
  • Vascular Patency
  • Vascular Surgical Procedures / adverse effects