Renal artery aneurysm (RAA) is a rare clinical entity with an incidence of 0.015-1%.
Indications for interventional or surgical repair of RAAs are expanding aneurysms,
diameter >2.5 cm, intractable renovascular hypertension, dissecting RAA, hematuria,
and renal infarction after distal embolization. Interventional insertion of a stent
graft as well as aortorenal bypass implantation are both low-risk procedures in simple
aneurysms of the proximal renal artery. However, complex distal renal aneurysms involving
several renal artery branches require not only an excellent result of vascular reconstruction,
but also a surgical technique offering maximal protection for the kidney during the
ischemic period. Here, we present a case of a solitary kidney with two consecutive
RAAs of segmental renal artery branches (type 2 RAA). A surgical strategy including
renal explantation, ex vivo renal preservation, ex vivo reconstruction of the renal
artery, and renal heterotopic autotransplantation was successfully applied. The technique
of ex vivo repair is a safe and effective surgical procedure in this clinical setting.
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© 2005 Annals of Vascular Surgery, Inc. Published by Elsevier Inc. All rights reserved.
