PDF(Pubmed)
Abstract：
Delayed presentation of recipient artery pseudoaneurysms following kidney transplantation is a rare, yet critical, complication. Although the precise etiology remains unclear, factors such as chronic steroid use, iatrogenic injuries (including vascular clamp damage during index surgery), or infections could contribute. Timely surgical intervention is imperative to prevent arterial rupture and life-threatening bleeding. Open repair, although commonly used, is associated with notable mortality rates and graft loss. Endovascular repair for delayed presentations of native iliac artery pseudoaneurysms has seen limited documentation in the literature. We present a case involving salvage of a kidney graft through innovative application of an endovascular technique using a modified stent graft with fenestration for the transplanted renal artery. The pseudoaneurysm, discovered 4 years after transplantation, was situated in proximity to the anastomosis site of the kidney graft\'s renal artery to recipient common iliac artery. Traditional open repair posed significant risks of graft loss due to its location near the kidney allograft. Our approach successfully resolved the issue, preserving graft function and resulting in a short length of hospital stay. This case contributes to the limited body of knowledge on delayed presentation of pseudoaneurysms after kidney transplantation. Successful application of an endovascular approach underscores its potential as a safe and effective alternative to open repair, offering favorable outcomes in terms of patient morbidity, mortality, and graft salvage.
摘要：
肾移植后受体动脉假性动脉瘤的延迟出现是罕见的，然而关键，并发症。尽管确切的病因尚不清楚，因素，如长期使用类固醇，医源性损伤（包括索引手术过程中的血管钳损伤），或者感染可能会有所贡献。及时的手术干预对于防止动脉破裂和危及生命的出血至关重要。打开修复,虽然常用，与显著的死亡率和移植物丢失有关。血管内修复术治疗自体髂动脉假性动脉瘤延迟表现的文献有限。我们介绍了一例涉及通过创新应用血管内技术来挽救肾脏移植物的案例，该技术使用了改良的支架移植物，并为移植的肾动脉开窗。假性动脉瘤,移植后4年发现，位于肾移植物肾动脉与受者髂总动脉的吻合部位附近。传统的开放式修复由于其位于同种异体肾脏附近，因此存在严重的移植物丢失风险。我们的方法成功地解决了这个问题，保留移植物功能，导致住院时间短。这种情况导致有关肾移植后假性动脉瘤延迟出现的知识有限。血管内方法的成功应用强调了其作为开放式修复的安全有效替代方法的潜力。在患者发病率方面提供有利的结果，死亡率,和移植救助。
