Ex-vivo Surgical Repair of a Renal Artery Aneurysm with Kidney Autotransplantation

Abstract

Renal artery aneurysms are rare. They are most commonly degenerative, congenital or due to medial fibroplasia. Proximal aneurysms can be repaired by endovascular and in-situ surgical techniques. However, aneurysms of the distal renal artery and its branches require ex-vivo surgical repair, also known as auto-transplantation: the kidney is removed, dissected and reconstructed in cold ischemia, and put back in place. A 69-year-old woman, with hypertension, presented with bilateral renal artery aneurysms with a diameter of 3.4 cm on the right kidney and 1 cm on the left kidney. The right renal artery aneurysm, which was due to medial fibroplasia, was successfully repaired using the ex-vivo surgical technique. Patency was confirmed by postoperative computed tomography angiography.