alexa Endovascular Repair of Late Onset Anastomosis Site Pseudoaneurysms Complicating Renal Transplantation
ISSN: 2329-6925

Journal of Vascular Medicine & Surgery
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Case Report

Endovascular Repair of Late Onset Anastomosis Site Pseudoaneurysms Complicating Renal Transplantation

Narayan Karunanithy FRCR1, Raphael Uwechue MRCS2, Francis Calder FRCS3, NizamMamode FRCS3, LetoMailli MD1, PankajChandak MRCS3, Mohamed Morsy MRCS4, Jiri Fronek FRCS5, David Makanjuola FRCP6, Derek Roebuck FRCR7 and Nicos Kessaris3*

1Department of Interventional Radiology, Guy’s & St Thomas’ NHS Foundation Trust, London, UK

2Department of General Surgery, Diana Princess of Wales Hospital, Grimsby, UK

3Department of Nephrology and Renal Transplantation, Guy’s & St Thomas’ NHS Foundation Trust, London, UK

4Department of Renal and Transplantation Surgery, St George’s Healthcare NHS Trust, London, UK

5Transplant Surgery Department, Institute for Clinical and Experimental Medicine, 2nd Medical Faculty, Charles University, Prague, Czech Republic

6South West Thames Renal and Transplantation Unit, Epsom and St Helier University Hospitals NHS Trust, Surrey, UK

7Department of Radiology, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK

*Corresponding Author:
NicosKessaris
Consultant Transplant Surgeon
Department of Nephrology and
Renal Transplantation,6th Floor
Borough Wing,Guy’s Hospital
Great Maze Pond, London SE1 9RT, UK
Tel: +44 (0) 2071887188,Ext: 53493
Fax: +44 (0) 2071885646
E-mail: [email protected]

Received Date: June 26, 2014; Accepted Date: September 18, 2014; Published Date: September 20, 2014

Citation: Narayan Karunanithy FRCR, Raphael Uwechue MRCS, Francis Calder FRCS, NizamMamode FRCS, LetoMailli MD, et al. (2014) Endovascular Repair of Late Onset Anastomosis Site Pseudoaneurysms Complicating Renal Transplantation. J Vasc Med Surg 2:156. doi:10.4172/2329-6925.1000156

Copyright: © 2014 Narayan Karunanithy FRCR, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License,which permits unrestricted use, distribution, and reproduction in any medium,provided the original author and source are credited.

 

Abstract

Introduction: Extra-renal anastomosis site pseudoaneurysms are a rare complication that can occur following renal transplantation. Expansion and rupture can lead to life threatening haemorrhage. Definitive treatment options include surgical and endovascular repair. Endovascular repair has shown early promise in management and benefits from being minimally invasive.

We report five patients treated with endovascular repair and discuss the factors that need to be considered to tailor individual endovascular treatment strategies.

Methods: Retrospective review of late onset cases of extra-renal pseudoaneurysms managed with endovascular repair at our institutions. Case histories, mode of presentation, imaging, endovascular technique and follow up were analysed. The location, size and configuration of the pseudoaneurysm and the likely underlying aetiology are studied.

Results: Between 2008 and 2013, five patients with six extra-renal pseudoaneurysms were identified. Three of these patients were on warfarin at the time of presentation. Technical success was 100% (6/6) following endovascular repair, with no significant procedure related complications. 5/6 (83%) required one procedure and 1/6 (17%) required three procedures. No recurrence demonstrated on clinical and imaging follow up.

Conclusions : Endovascular repair is safe and effective in treatment of anastomosis site pseudoaneurysms and results in durable mid-term outcome

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