EVAR Approach for Abdominal Aortic Aneurysm with Horseshoe Kidney: A Multicenter Experience Academic Article in Scopus uri icon

abstract

  • © 2019 Elsevier Inc.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.

publication date

  • July 1, 2019