Endovascular Repair of Large Iliac Artery Pseudoaneurysm after Remote Transplant Nephrectomy

Abstract

This case study focuses on a 49-year-old woman several years after a right transplant nephrectomy for delayed renal hemorrhage. The patient had an incidental finding of a right external iliac artery pseudoaneurysm measuring 8.1 cm at its largest dimension. Of note, the patient had undergone cardiac catheterization several months prior with right common femoral artery access. This study aimed to implement endovascular repair of posttransplant nephrectomy iliac artery pseudoaneurysms as a less invasive treatment option as compared with open repair in suitable candidates. Percutaneous access of the right common femoral artery with the deployment of a 9 × 50 mm covered stent within the right external iliac artery with the successful exclusion of the pseudoaneurysm. Postoperative course was uncomplicated, and the patient was discharged home on dual antiplatelet therapy. The patient's symptoms completely resolved after the intervention. She underwent follow-up surveillance scans, which redemonstrated a patent external iliac stent and excluded pseudoaneurysm. Endovascular repair with a covered stent for posttransplant nephrectomy iliac artery pseudoaneurysms is a safe, minimally invasive, and valuable treatment option in the absence of underlying infection.

Keywords

pseudoaneurysm - iliac artery - transplant - nephrectomy - endovascular - stent - angioplasty - complication

Publication History

Article published online:
28 November 2024

• References

• 1 Borges L, Oliveira N, Dias E, Cássio I. Iliac artery pseudoaneurysm: a rare complication following allograft nephrectomy. BMJ Case Rep 2014; 2014: bcr2013202596
• 2 Veean S, Patel N, Lee D, Vo H, Rotem E. A long-standing external iliac artery pseudoaneurysm in a patient with a history of a failed kidney transplant. Radiol Case Rep 2016; 11 (04) 354-356
• 3 Akoh JA. Transplant nephrectomy. World J Transplant 2011; 1 (01) 4-12
• 4 Eng MM, Power RE, Hickey DP, Little DM. Vascular complications of allograft nephrectomy. Eur J Vasc Endovasc Surg 2006; 32 (02) 212-216
• 5 Blohmé I, Brynger H. Emergency ligation of the external iliac artery. Ann Surg 1985; 201 (04) 505-510
• 6 McIntosh BC, Bakhos CT, Sweeney TF, DeNatale RW, Ferneini AM. Endovascular repair of transplant nephrectomy external iliac artery pseudoaneurysm. Conn Med 2005; 69 (08) 465-466
• 7 Peel RK, Patel J, Woodrow G. Iliac artery false aneurysm following renal allograft: presentation with non-specific inflammatory response and treatment by endovascular stent graft. Nephrol Dial Transplant 2003; 18 (09) 1939-1940
• 8 Bracale UM, Porcellini M, del Guercio L, Bracale G. Embolization of a symptomatic pseudoaneurysm developing after transplant nephrectomy. Intern Med 2013; 52 (02) 291-292
• 9 Fornaro J, Marincek B, Jungius KP. Pseudoaneurysm in the iliac fossa after renal transplantation–treatment with ultrasound-guided thrombin injection. Abdom Imaging 2007; 32 (01) 50-52
• 10 Squizzato F, Mosquera-Rey V, Zanabili Al-Sibbai A. et al. Outcomes of self-expanding covered stents for the treatment of external iliac artery obstructive disease. Cardiovasc Intervent Radiol 2023; 46 (05) 579-587