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EVAR Approach for Abdominal Aortic Aneurysm with Horseshoe Kidney: A Multicenter Experience.

Abstract：

BACKGROUND:Horseshoe kidney is a congenital abnormality, with an incidence of 0.25% of the total population. Only 0.12% of patients who undergo an abdominal aortic aneurysm repair might also have a coexisting horseshoe kidney. We present a series of 10 cases auspiciously treated with an endovascular approach along with their respective patient evolutions. A review of the literature is also presented. MATERIALS AND METHODS:A retrospective review of the medical records (January 2004-December 2013) of 10 patients with abdominal aortic aneurysms and horseshoe kidney treated with endovascular repair was done. Patients were treated at 6 different centers in 3 different countries. Demographics, clinical status, medical history, anatomical morphology of the aneurysms and kidneys, as well as surgical outcomes were all analyzed. RESULTS:The median age was 67.5 years (range 47-81), and the median aortic aneurysmal diameter was 57 mm (49-81 mm). A total of 35 arteries provided renal perfusion. There were 13 right renal arteries and 13 left renal arteries, all successfully preserved, with 9 isthmus arteries covered. Median hospital stay consisted of 3.5 days (1-14 days). All aortic aneurysms were successfully excluded with no endoleaks, hematomas, wound infections, or renal failure. During a median follow-up of 7 years, 3 patients died of myocardial infarction 7 years after endovascular aortic repair (EVAR), and the other 7 patients are doing well, with a median aneurysm reduction size sac of 16.5 mm. CONCLUSIONS:Endovascular repair is a safe and efficient endovascular option for the treatment of patients presenting concomitant aortic aneurysm and horseshoe kidney, with excellent short- and medium-term outcomes. To our knowledge, our study represents the largest series of cases with horseshoe kidney successfully treated via EVAR without significant complications.

journal_name

Ann Vasc Surg

journal_title

Annals of vascular surgery

authors

Fabiani MA,González-Urquijo M,Riambau V,Vaquero Puerta C,Mosquera Arochena NJ,Varona Frolov S,Maldonado TS

doi

10.1016/j.avsg.2018.10.042

subject

Has Abstract

pub_date

2019-07-01 00:00:00

pages

232-237

eissn

0890-5096

issn

1615-5947

pii

S0890-5096(19)30064-0

journal_volume

58

pub_type

杂志文章,多中心研究,评审

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