Diagnosis and management of the [lsquo ]difficult[rsquo ] abdominal aortic aneurysm: Pararenal aneurysms, inflammatory aneurysms, and horseshoe kidney

2001 ◽  
Vol 14 (4) ◽  
pp. 312-317 ◽  
Author(s):  
Karl A. Illig ◽  
Richard M. Green
Keyword(s):  
Abdominal Aortic Aneurysm ◽  
Aortic Aneurysm ◽  
Horseshoe Kidney ◽  
Diagnosis And Management ◽  
Abdominal Aortic

Ruptured Abdominal Aortic Aneurysm and Horseshoe Kidney: Isthmus Sectioning By Endo GIA

2019 ◽  
Vol 53 (7) ◽  
pp. 599-601
Author(s):  
Pagliariccio Gabriele ◽  
Gatta Emanuele ◽  
Carlo Grilli Cicilioni ◽  
Schiavon Sara ◽  
Carbonari Luciano
Keyword(s):  
Abdominal Aortic Aneurysm ◽  
Aortic Aneurysm ◽  
Horseshoe Kidney ◽  
Ruptured Abdominal Aortic Aneurysm ◽  
Aortic Graft ◽  
Urinary Leakage ◽  
Aortic Neck ◽  
Abdominal Aortic ◽  
Open Surgical Approach ◽  
Graft Reconstruction

Introduction: A 90-year-old patient was admitted with a hemorrhagic shock from a huge ruptured abdominal aortic aneurysm with an unfavourable infrarenal aortic neck and a horseshoe kidney (HSK). Report: We decided on an open surgical approach: the HSK isthmus was sectioned with an Endo GIA 45 mm, and we performed a suprarenal aortic cross-clamping and an aortic graft reconstruction. Postoperatively, no urinary leakage was detected, and renal function showed no impairment. The patient died on the 10th postoperative day from pneumonia. Conclusion: We believe that the sectioning of the HSK isthmus with Endo GIA is a fast and simple maneouvre.

EVAR in Patients With Abdominal Aortic Aneurysm and Horseshoe Kidney: A Systematic Review

2021 ◽  
pp. 152660282110594
Author(s):  
Mauricio Gonzalez-Urquijo ◽  
Diana Paola Padilla-Armendariz ◽  
David Eugenio Hinojosa-Gonzalez ◽  
Gerardo Lozano-Balderas ◽  
Eduardo Flores-Villalba ◽  
...  
Keyword(s):  
Systematic Review ◽  
Abdominal Aortic Aneurysm ◽  
Aortic Aneurysm ◽  
Operative Time ◽  
Endovascular Aneurysm Repair ◽  
Horseshoe Kidney ◽  
Complication Rates ◽  
Abdominal Aortic ◽  
Endovascular Approach ◽  
Aneurysm Repair

Purpose: A systematic review of all patients that have been reported in the literature with abdominal aortic aneurysm (AAA) concomitant with horseshoe kidney (HSK) treated electively by endovascular aneurysm repair (EVAR) is presented. A new grouping system for describing HSK vasculature is implemented. Materials and Methods: We searched for published manuscripts using the Medical Subject Headings terms “abdominal aortic aneurysm,” “AAA,” “EVAR,” “endovascular aneurysm repair,” and “horseshoe kidney” in PubMed, Google Scholar, Scopus, and National Center for Biotechnology Information databases. Inclusion criteria include all published material of patients with AAA with HSK treated electively by an endovascular approach. We excluded patients who were treated by a hybrid or open repair or patients with ruptured AAA. Statistical analysis was carried out using SPSS Statistics version 25 (IBM Corp, Armonk, New York) software. Results: A total of 50 patients from 30 studies were included for analysis. Males made up 88% (n=44) of the population. The median age for this cohort was 70 years (range: 47–86 years). Median aneurysmal diameter was 6.0 cm (range: 4.0–10.3 cm). The median operative time for endovascular repair was 84 minutes (range: 40–332 minutes). The most common graft used was Zenith, used in 40% (n=20) of the cases, followed by Endurant in 14% (n=7). The overall complication rate was 14% (n=7). The median follow-up was 19 months (range: 1–108 months). While comorbidities did not appear to impact outcomes significantly, median operative times for smokers were higher than those in nonsmokers, 84 versus 118 minutes, respectively (p=0.048). Univariate linear regression modeling of aneurysmal size with age, operative time, and length of stay revealed a significant coefficient association between aneurysmal size and operative times. After adjusting for comorbidities and aneurysmal size, prior history of chronic kidney disease significantly increased odds for renal infarction. Conclusion: This review presents the most complete data set possible of patients with concomitant HSK and AAA treated by an endovascular approach. Furthermore, the A + B + C classification for grouping the HSK vasculature is implemented. This systematic review suggests EVAR to be an excellent option with low complication rates for the treatment of AAA in patients with HSK.

scholarly journals Nyitott hasi aortaaneurysma-műtétek patkóvese fennállása esetén

2020 ◽  
Vol 161 (46) ◽  
pp. 1966-1971
Author(s):  
Sándor Bálint ◽  
Zsuzsanna Mihály ◽  
Zoltán Oláh ◽  
Péter Sótonyi
Keyword(s):  
Abdominal Aortic Aneurysm ◽  
Aortic Aneurysm ◽  
Horseshoe Kidney ◽  
Emergency Operation ◽  
Limb Ischaemia ◽  
Abdominal Aneurysm ◽  
Vascular Surgeon ◽  
Accessory Renal Artery ◽  
First Case ◽  
Abdominal Aortic

Összefoglaló. A patkóvese a vese leggyakrabban előforduló fejlődési rendellenességeinek egyike. Hasi aortaaneurysmával való együttes előfordulása kifejezetten ritka (a hasi aortaaneurysmás esetek 0,12%-a). Az első esetben egy 64 éves férfi akut alsó végtagi panaszokkal került felvételre. A CT-angiográfia patkóvesét és thrombotizált infrarenalis aortaaneurysmát igazolt. Az akut műtét során a hasi aortaaneurysma resectióját és aortobifemoralis bypassműtétet végeztünk a patkóvese ishmusának megtartásával. A második esetben hasi panaszokat okozó, mindkét arteria iliaca communisra ráterjedő infrarenalis aortaaneurysma esetén végeztünk aortobiiliacalis rekonstrukciót. Az aneurysma előtt elhelyezkedő isthmus tervezetten szétválasztásra került, a poláris veseartériát visszaültettük. A tünetes hasi aortaaneurysma abszolút műtéti indikációt képez. A preoperatív CT- vagy MR-angiográfia kulcsfontosságú mind a műtéti indikáció felállítása, mind pedig a műtét megtervezése szempontjából. A beavatkozás előtt pontos képet kell kapnia az érsebésznek az aorta anatómiája mellett a patkóvese vérellátásáról és a húgyúti rendszerről. Az érsebészeti rekonstrukció esetén a transperitonealis feltárás – főleg akut műtét esetén – több előnnyel rendelkezik, mint a retroperitonealis feltárás. Orv Hetil. 2020; 161(46): 1966–1971. Summary. Horseshoe kidney is one of the most common congenital disorders of the kidney. The simultaneous incidence of horseshoe kidney and abdominal aneurysm is very low (0.12% of all cases of abdominal aortic aneurysm). In the first case, a 64-year-old male patient was admitted with acute lower limb ischaemia. CT-angiography revealed an occluded aortic aneurysm. During the emergency operation, the abdominal aneurysm was resected and an aortobifemoral bypass procedure was performed sparing the kidney’s isthmus. In the second case, the abdominal complaints were caused by an infrarenal abdominal aneurysm that involved both common iliac arteries. Aortobiiliac reconstruction was performed with planned separation of the kidney isthmus and reimplantation of the accessory renal artery. Symptomatic abdominal aortic aneurysm is an urgent indication for reconstruction. The preoperative CT- or MR-angiography play a key role in the indication and planning of the reconstruction. It is highly important for the vascular surgeon to have a clear picture of the blood supply of the horseshoe kidney and the urinary tract along with the anatomy of the aorta before the operation. The transperitoneal approach has several advantages over the retroperitoneal approach during vascular reconstruction surgery. Orv Hetil. 2020; 161(46): 1966–1971.

scholarly journals A Case of Ruptured Abdominal Aortic Aneurysm with Horseshoe Kidney

2012 ◽  
Vol 41 (5) ◽  
pp. 235-237 ◽  
Author(s):  
Hiroyuki Watanabe ◽  
Shigeyasu Takeuchi ◽  
Mitsunori Okimoto ◽  
Hisanori Fujita
Keyword(s):  
Abdominal Aortic Aneurysm ◽  
Aortic Aneurysm ◽  
Horseshoe Kidney ◽  
Ruptured Abdominal Aortic Aneurysm ◽  
Abdominal Aortic

Abdominal Aortic Aneurysm Associated with Horseshoe Kidney

Angiology ◽  
1970 ◽  
Vol 21 (2) ◽  
pp. 124-129 ◽  
Author(s):  
Samuel A. Marable ◽  
Neil R. Thomford
Keyword(s):  
Abdominal Aortic Aneurysm ◽  
Aortic Aneurysm ◽  
Horseshoe Kidney ◽  
Abdominal Aortic
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