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Renal artery reconstruction

Michihisa Umetsu, Hitoshi Goto, Masato Ohara, Munetaka Hashimoto, Takuya Shimizu, Daijirou Akamatsu, Ken Tsuchida, Yuta Tajima, Shunya Suzuki, Keisuke Yamamoto, Shigehito Miyagi, Michiaki Unno, Takashi Kamei
Objective : Renal artery aneurysm (RAA) is an uncommon disease, the natural course of which is still not well known. The objective of this study is to define factors that affect the growth rate of RAAs. Materials and Methods : We retrospectively reviewed 32 aneurysms in 26 patients at our institute between January 2010 and March 2016. Basal demographics, comorbidities, reason for diagnosis, and details of the aneurysms and interventions were recorded. The chronological changes in the diameter of the RAA using multiplanar reconstructions of computed tomography images were measured and analyzed...
December 25, 2017: Annals of Vascular Diseases
Huanrui Hu, Xiyang Chen, Zhoupeng Wu, Jichun Zhao, Bin Huang, Yukui Ma, Ding Yuan, Yi Yang, Fei Xiong
We report an aneurysm degeneration of a vein graft in a previous aortorenal bypass performed five years earlier for severe right renal artery stenosis due to Takayasu arteritis. The patient was a 31-year-old woman who suffered from refractory hypertension. The autogenous bypass adopting great saphenous vein was performed from her infrarenal abdominal aorta to her right renal artery. Five years after the operation, the patient complained vague discomfort in her abdomen. Three-dimensional computed tomography angiography reconstruction demonstrated the existence of an aneurysm with a maximum diameter of 1...
March 1, 2018: Annals of Vascular Surgery
Matias E Czerwonko, Pablo Huespe, Cristina M Elizondo, Juan Pekolj, Adrian Gadano, Laura Barcán, Sung-Ho Hyon, Eduardo de Santibañes, Martín de Santibañes
BACKGROUND: Adult liver recipients (ALR) differ from the general population with pyogenic liver abscess (PLA) as they exhibit: reconstructed biliary anatomy, recurrent hospitalizations, poor clinical condition and are subjected to immunosuppression. The aim of this study was to identify risk factors associated with PLA in ALR and to analyze the management experience of these patients. METHODS: Between 1996 and 2016, 879 adult patients underwent liver transplantation (LT), 26 of whom developed PLA...
February 26, 2018: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
Konstantinos Spanos, Tilo Kölbel, George Kouvelos, Nikolaos Tsilimparis, Sebastian E Debus, Athanasios D Giannoukas
INTRODUCTION: The repair of long-term complications of open abdominal aortic repair such as para-anastomotic aneurysm (PAA) and pseudoaneurysm (PSA) is very challenging. The aim of this study was to assess the outcomes of endovascular repair of PAA/PSA after previous open aortic surgery for aneurismal or occlusive disease. EVIDENCE ACQUISITION: A systematic review was undertaken; a search was performed (PRISMA) in MEDLINE, CENTRAL, Cochrane databases and key references of all studies of endovascular treatment of PAA/PSA after open aortic surgery...
February 8, 2018: Journal of Cardiovascular Surgery
Luyun Fan, Wenjun Ma, Huimin Zhang, Jun Cai
RATIONALE: Iliac arterial fibromuscular dysplasia (FMD) was rarely reported and its demographic, clinical, and imaging features have not been precisely described resulting in uncertain therapeutic methods. PATIENT CONCERNS: A 31-year-old man was referred because of 3-month-ago onset hypertension, low serum potassium, and a small-sized right kidney with normal renal artery under ultrasound examination. This patient was suspected of primary aldosteronism, whereas spirolactone was poorly effective...
December 2017: Medicine (Baltimore)
Mathias Meyer, Holger Haubenreisser, Christoph Schabel, Christianne Leidecker, Bernhard Schmidt, Stefan O Schoenberg, Thomas Henzler
Adverse effects of intravenous contrast media (CM) in patients with renal risk factors and acute kidney injury are still controversially discussed. The aim of this study was to investigate whether dual-energy (DE) pulmonary CT angiography (CTPA) in combination with a noise optimized virtual monoenergetic imaging algorithm allows for a reduction of CM. This IRB-approved study comprised 150 patients with suspected pulmonary embolism (78 male; mean age 65 ± 17years). 50 patients with acute/chronic renal failure were examined on a 3rd generation dual-source CT with an optimized DE CTPA protocol and a low CM injection protocol (5...
January 31, 2018: Scientific Reports
Jiang Xiong, Zhongzhou Hu, Hongpeng Zhang, Huanming Xu, Duanduan Chen, Wei Guo
Surgeon-modified retrograde branched extension limb assembling technique and bridged endografts were successfully used to exclude an asymptomatic pararenal abdominal aortic aneurysm and to reconstruct the superior mesenteric artery and bilateral renal arteries in a case with high-grade celiac artery stenosis, nondilated aorta above the superior mesenteric artery, and large lumen below the renal arteries. In patient-specific models for hemodynamics analysis, enhanced flow diversion to visceral arteries up to 6-month follow-up confirmed treatment feasibility; however, endograft configurations could be improved to avoid sharp corners at bifurcations, thereby ensuring smooth flow transport and possibly reducing risk for endograft narrowing or the development of thrombosis...
June 2017: Journal of Vascular Surgery Cases and Innovative Techniques
Heung Bae Kim, Gabriel J Ramos-Gonzalez, Khashayar Vakili, Deborah R Stein, Michael A Ferguson, Diego Porras, James E Lock, Gulraiz Chaudry, Ahmad Alomari, Steven J Fishman
BACKGROUND: Midaortic syndrome (MAS) is a rare condition characterized by stenosis of the abdominal aorta. Patients with disease refractory to medical management will usually require either endovascular therapy or surgery with use of prosthetic graft material for bypass or patch angioplasty. We report our early experience with a novel approach using a tissue expander (TE) to lengthen the normal native arteries in children with MAS, allowing primary aortic repair without the need for prosthetic graft material...
January 13, 2018: Journal of Vascular Surgery
Yohei Yamamoto, Yoshinori Inoue, Tsuyoshi Ichinose, Masato Nishizawa, Kimihiro Igari, Takahiro Toyofuku, Toshifumi Kudo
In Behçet's disease (BD) patients, endovascular repair is a reasonable alternative treatment for aortic aneurysms to avoid postoperative anastomotic pseudoaneurysms. However, there are some complications that may occur after endovascular repair. We herein report the case of a 40-year-old man with active BD developed recurrent aortic pseudoaneurysms at the proximal and distal margins of the stent graft and a femoral puncture site pseudoaneurysm 3 months after endovascular abdominal aortic aneurysm (AAA) repair...
January 15, 2018: Annals of Thoracic and Cardiovascular Surgery
Francesco Porpiglia, Cristian Fiori, Enrico Checcucci, Daniele Amparore, Riccardo Bertolo
BACKGROUND: Available technologies could avoid global ischemia for the removal of a renal tumor. OBJECTIVE: To present hyperaccuracy three-dimensional (HA3D) reconstruction during robot-assisted partial nephrectomy (RAPN) and compare its efficacy in sponsoring successful selective clamping of renal arterial branches during RAPN. DESIGN, SETTING, AND PARTICIPANTS: Patients undergoing RAPN (January 2016-July 2017) for renal mass PADUA score ≥10 who underwent abdominal computed tomography scan with angiography...
January 6, 2018: European Urology
Eike S Debus, Tilo Kölbel, Anna Duprée, Günter Daum, Harleen L Sandhu, Daniel Manzoni, Sabine H Wipper
BACKGROUND: The hybrid SPIDER-graft consists of a proximal descending aortic stent graft and a conventional six branched Dacron graft for open abdominal aortic repair. Technical feasibility with regard to avoiding thoracotomy and extracorporeal circulation (ECC) during thoraco-abdominal aortic hybrid repair and peri-procedural safety of this novel device are unknown. MATERIAL AND METHODS: This was a feasibility and safety study in domestic pigs (75-85 kg). The abdominal aorta including iliac bifurcation, left renal artery, and visceral arteries were exposed via retroperitoneal access...
December 28, 2017: European Journal of Vascular and Endovascular Surgery
L Irace, J Ben Hamida, O Martinelli, R Stumpo, F G Irace, S Venosi, R Gattuso, P B Berloco, B Gossetti
AIM: The purpose of this paper is to evaluate the mid and long terms outcomes of open and endovascular surgical treatment, as well as multilayer stent, in patients affected by Renal Artery Aneurysm (RAA). PATIENTS AND METHODS: Twenty five patients with RAA (24 monolateral and 1 bilateral aneurysm, 26 aneurysms) were observed between 2000 and 2015: 4 were not treated due to the small size of the aneurysm (< 2.5 cm); out of the remaining, 16 underwent endovascular treatment, 2 were treated by open surgery consisting in aneurysmectomy and graft reconstruction and 5 (in 1 patient bilateral) were treated by ex vivo repair and autotransplantation...
September 2017: Il Giornale di Chirurgia
Sohrab Arora, Logan Campbell, Mouafak Tourojman, Daniel Pucheril, Lamont R Jones, Craig Rogers
OBJECTIVE: To demonstrate robot-assisted ureterolysis and buccal mucosal graft (BMG) ureteroplasty for the management of a complex, long recurrent ureteral stricture developing after ureterolysis, and also to demonstrate the use of near-infrared fluorescence (NIRF) imaging and intraoperative ureteroscopy during this procedure. METHODS: A 58-year-old man with a history of cabergoline treatment and a cardiac catheterization through the left groin presented with left flank pain and hydronephrosis...
December 2017: Urology
A J Vicéns-Morton, C Callaghan, J Olsburgh
Introduction: Live donors, extended donor criteria, and the maximum usage of organs with anatomical variants are some of the mechanisms used to increase the number of organs available. Case: We present the case of a kidney transplant, in which the organ had an iatrogenic injury to a lower pole arterial branch during retrieval. The donor was a 35-year-old male (DCD, Maastricht III). The right kidney was accepted; it had three veins in a single cava patch and three renal arteries, the main artery with aorta patch that is 8 cm long...
2017: Case Reports in Transplantation
Hiroyuki Ogasawara, Chikashi Nakanishi, Shigehito Miyagi, Kazuaki Tokodai, Yasuyuki Hara, Wataru Nakanishi, Koji Miyazawa, Kenji Shimizu, Hiroyuki Kumata, Hitoshi Goto, Masafumi Goto, Michiaki Unno, Takashi Kamei
In adult liver transplantation, renoportal anastomosis (RPA) has been introduced as a useful technique for patients with grade 4 portal vein thrombosis and a splenorenal shunt. Here, we report a pediatric case in which RPA allowed a left lateral lobe living donor liver transplantation (LDLT) despite portal vein thrombosis and a large splenorenal shunt. At 36 days old, the patient underwent a Kasai operation for biliary atresia. At 17 months old, she underwent LDLT because of repetitive cholangitis. Pretransplant examinations revealed a large splenorenal shunt and portal vein thrombosis...
September 2017: Case Reports in Gastroenterology
Bipin Chandra Pal, Pranjal R Modi, Syed Jamal Rizvi, Rohit Chauhan, Suresh Kumar, Shruti P Gandhi, Vivek B Kute, Hargovind L Trivedi
Aim: Complex vascular anatomy poses a major challenge to the donor surgeon. Here, we have described the technical nuances in retroperitoneoscopic living donor nephrectomy for the left kidney in the situations of a rare vascular anomaly of duplication of inferior vena. Materials and Methods: Between September 2005 and June 2016, 1460 retroperitoneoscopic living donor nephrectomy were carried out in single surgical unit of our institution. Out of these four donors were found to have duplication of inferior vena cava (IVC)...
October 2017: Urology Annals
Mahir Kırnap, Ümit Özçelik, Aydıncan Akdur, Ebru H Ayvazoğlu Soy, İclal Işıklar, Feza Yarbuğ Karakayalı, Gökhan Moray, Mehmet Haberal
Traumatic external iliac artery dissection after renal transplant is a rare complication, but it should be urgently managed due to its devastating effects on graft and lower limb circulation. External iliac artery dissection is seen more in recipients with diabetes mellitus and comorbid disease. Recipients with external iliac artery dissection should be treated immediately by percutaneus angioplasty or surgical reconstruction. In this study, we reported the management of 2 kidney transplant cases with external iliac artery dissection due to vascular clamping of the artery...
October 31, 2017: Experimental and Clinical Transplantation
Monty A Aghazadeh, Alvin C Goh
OBJECTIVE: To demonstrate a novel supine, single-dock approach for robotic nephrectomy and inferior vena cava (IVC) thrombectomy for a left-sided renal cell carcinoma with level II IVC thrombus. METHODS: We perform robotic nephrectomy and IVC thrombectomy in a 79-year-old man with a 6-cm left renal mass and level II IVC thrombus. For this approach, the patient is placed in steep Trendelenburg, and a 6-port transperitoneal technique is used, with the robot docked such that the arms are oriented in a cephalad direction...
October 26, 2017: Urology
Bhavan Prasad Rai, Amit Patel, Ahmed Abroaf, Narin Suleyman, Shanmugasundaram Gowriemohan, Venkat Prasad, Nikhil Vasdev, Jim Adshead
Introduction: External validation of four nephrometry scores (NS): Centrality index (C-index), arterial based complexity (ABC), preoperative aspects and dimensions used for an anatomical (PADUA) and radius expohytic/endophytic nearness anterior/posterior location (RENAL) scoring systems in patients who have undergone trans-peritoneal robotic assisted partial nephrectomy (RAPN). Material and methods: A prospective database for RAPN has been maintained. Individual NSs were performed on 3-dimensional reconstructions of MDCT/MRI studies retrospectively by a board certified uroradiologist...
2017: Central European Journal of Urology
Hai-Bin Wei, Xiao-Long Qi, Feng Liu, Jie Wang, Xiao-Feng Ni, Qi Zhang, En-Hui Li, Xuan-Yu Chen, Da-Hong Zhang
After publication of this work [1] it was noticed the author - Jie Wang's name was in the wrong order. The original article was corrected. The publisher apologises for this error.
November 3, 2017: BMC Urology
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