TY - JOUR
T1 - Treatment of Renal Artery Aneurysm by ex situ Repair and Autotransplantation
T2 - A Nationwide Cohort Study
AU - Fang, Yitian
AU - Kimenai, Hendrikus J A N
AU - de Bruin, Ron W F
AU - Dutch Kidney Transplant Study Group
AU - de Vries, Dorottya K
AU - Petri, Bart-Jeroen
AU - Warlé, Michiel C
AU - Tielliu, Ignace F J
AU - van Laanen, Jorinde
AU - Idu, Mirza M
AU - Pol, Robert A
AU - Minnee, Robert C
N1 - Publisher Copyright:
© 2024 The Author(s). Published by S. Karger AG, Basel.
PY - 2024/10/4
Y1 - 2024/10/4
N2 - INTRODUCTION: Renal artery aneurysm (RAA) is a rare vascular disease with a mortality rate of up to 80% upon rupture. This study aimed to investigate the safety and efficacy of ex situ repair and autotransplantation for endovascularly untreatable RAA.METHODS: A retrospective nationwide cohort study was conducted in RAA patients undergoing ex situ repair and autotransplantation in the Netherlands. Surgical techniques, postoperative complications, and graft outcomes were assessed.RESULTS: Ex situ repair was performed in 9 patients with 11 RAAs. Eight RAAs were located at the first bifurcation, one on the main trunk, one on the first branch, and one on the second branch. Nephrectomy was performed via laparoscopy (n = 7), robotic-assisted laparoscopy (n = 1), and laparotomy (n = 1). Postoperative complications were recorded in 4 patients, including bowel obstruction, delirium, pneumonia, and hydronephrosis due to double-J dislocation. The median estimated glomerular filtration rate was 83 mL/min/1.73 m2 pretransplant and 88 mL/min/1.73 m2 posttransplant. By an average follow-up of 32 months, 2 patients had died due to lung adenocarcinoma and stroke, while all autotransplanted kidneys had good patency and remained functional.CONCLUSIONS: Ex situ repair and autotransplantation are safe and feasible for endovascularly untreatable RAA cases. Larger cohorts with longer follow-up periods are necessary to further evaluate the role of this surgical approach.
AB - INTRODUCTION: Renal artery aneurysm (RAA) is a rare vascular disease with a mortality rate of up to 80% upon rupture. This study aimed to investigate the safety and efficacy of ex situ repair and autotransplantation for endovascularly untreatable RAA.METHODS: A retrospective nationwide cohort study was conducted in RAA patients undergoing ex situ repair and autotransplantation in the Netherlands. Surgical techniques, postoperative complications, and graft outcomes were assessed.RESULTS: Ex situ repair was performed in 9 patients with 11 RAAs. Eight RAAs were located at the first bifurcation, one on the main trunk, one on the first branch, and one on the second branch. Nephrectomy was performed via laparoscopy (n = 7), robotic-assisted laparoscopy (n = 1), and laparotomy (n = 1). Postoperative complications were recorded in 4 patients, including bowel obstruction, delirium, pneumonia, and hydronephrosis due to double-J dislocation. The median estimated glomerular filtration rate was 83 mL/min/1.73 m2 pretransplant and 88 mL/min/1.73 m2 posttransplant. By an average follow-up of 32 months, 2 patients had died due to lung adenocarcinoma and stroke, while all autotransplanted kidneys had good patency and remained functional.CONCLUSIONS: Ex situ repair and autotransplantation are safe and feasible for endovascularly untreatable RAA cases. Larger cohorts with longer follow-up periods are necessary to further evaluate the role of this surgical approach.
UR - http://www.scopus.com/inward/record.url?scp=85208204058&partnerID=8YFLogxK
U2 - 10.1159/000541814
DO - 10.1159/000541814
M3 - Article
C2 - 39369696
SN - 0014-312X
VL - 65
SP - 123
EP - 129
JO - European Surgical Research
JF - European Surgical Research
IS - 1
ER -