Aortic stent-grafts in patients with renal transplants

Purpose: To report the endovascular treatment of abdominal aortic aneurysms (AAA) in 2 patients with pelvic renal transplants. Methods and Results: Two men with multiple comorbidities and pelvic transpl ant kidneys underwent endovascular AAA repair using an aortomonoiliac syste m with femorofemoral bypass grafting. The arterial end-to-side anastomosis in both patients was to the external iliac artery. Tapered aortomonoiliac g rafts were fashioned from Gianturco Z-stents covered with Dacron graft mate rial and implanted with the distal attachment site in the iliac system ipsi lateral to the transplant kidney arterial anastomosis. The body of the sten t-graft was reinforcement with a Wallstent in each case before the contrala teral common iliac artery was occluded and the cross-femoral bypass constru cted. Both patients recovered uneventfully from the procedure and are free of endoleak or other complications related to their aneurysm repair at 7 an d 34 months. Conclusions: The presence of a pelvic renal transplant in a patient undergo ing endovascular AAA repair increases the complexity of procedural planning and endograft implantation, but a good outcome can be achieved.