Skip to main content
Top
Published in: CardioVascular and Interventional Radiology 11/2016

01-11-2016 | Case Report

Diagnosis and Management of Transplanted Kidney Extrarenal Pseudoaneurysms: A Series of Four Cases and a Review of the Literature

Authors: Ghaneh Fananapazir, Gemmy Hannsun, Luke A. Wright, Michael T. Corwin, Christoph Troppmann

Published in: CardioVascular and Interventional Radiology | Issue 11/2016

Login to get access

Abstract

Extrarenal pseudoaneurysms of transplanted kidneys are very rare but can have devastating consequences. In the past, these extrarenal pseudoaneurysms have often led to graft loss as well as significant morbidity and mortality. The role of advanced diagnostic imaging studies and of modern radiologic interventional management has not been studied. In this case series, we present four cases of extrarenal pseudoaneurysms of transplanted kidneys, describe the clinical scenarios and imaging that led to the angiographic diagnosis, and discuss the various endovascular and surgical approaches to management.
Literature
1.
go back to reference Bracale UM, Carbone F, del Guercio L, Viola D, D’Armiento FP, Maurea S, et al. External iliac artery pseudoaneurysm complicating renal transplantation. Interact CardioVasc Thorac Surg. 2009;8(6):654–60.CrossRefPubMed Bracale UM, Carbone F, del Guercio L, Viola D, D’Armiento FP, Maurea S, et al. External iliac artery pseudoaneurysm complicating renal transplantation. Interact CardioVasc Thorac Surg. 2009;8(6):654–60.CrossRefPubMed
2.
go back to reference Akgul E, Binokay F, Aikimbaev K, Aksungur EH. Extrarenal pseudoaneurysm of the arterial anastomosis in a renal transplant: endovascular coil embolization with balloon remodeling technique. Ren Fail. 2011;33(4):452–5.CrossRefPubMed Akgul E, Binokay F, Aikimbaev K, Aksungur EH. Extrarenal pseudoaneurysm of the arterial anastomosis in a renal transplant: endovascular coil embolization with balloon remodeling technique. Ren Fail. 2011;33(4):452–5.CrossRefPubMed
3.
go back to reference Duwe KM, Newhouse JH, Fayter J, Stern L, Budorick NE. Conservative management of an extrarenal pseudoaneurysm after percutaneous needle biopsy of a renal allograft. J Ultrasound Med. 2000;19(4):281–4.PubMed Duwe KM, Newhouse JH, Fayter J, Stern L, Budorick NE. Conservative management of an extrarenal pseudoaneurysm after percutaneous needle biopsy of a renal allograft. J Ultrasound Med. 2000;19(4):281–4.PubMed
4.
go back to reference Tobben PJ, Zajko AB, Sumkin JH, Bowen A, Fuhrman CR, Skolnick ML, et al. Pseudoaneurysms complicating organ transplantation: roles of CT, duplex sonography, and angiography. Radiology. 1988;169(1):65–70.CrossRefPubMedPubMedCentral Tobben PJ, Zajko AB, Sumkin JH, Bowen A, Fuhrman CR, Skolnick ML, et al. Pseudoaneurysms complicating organ transplantation: roles of CT, duplex sonography, and angiography. Radiology. 1988;169(1):65–70.CrossRefPubMedPubMedCentral
5.
go back to reference Peel RK, Patel J, Woodrow G. Iliac artery false aneurysm following renal allograft: presentation with non-specific inflammatory response and treatment by endovascular stent graft. Nephrol Dial Transplant. 2003;18(9):1939–40.CrossRefPubMed Peel RK, Patel J, Woodrow G. Iliac artery false aneurysm following renal allograft: presentation with non-specific inflammatory response and treatment by endovascular stent graft. Nephrol Dial Transplant. 2003;18(9):1939–40.CrossRefPubMed
6.
go back to reference Luzzio CC, Waclawik AJ, Gallagher CL, Knechtle SJ. Iliac artery pseudoaneurysm following renal transplantation presenting as lumbosacral plexopathy. Transplantation. 1999;67(7):1077–8.CrossRefPubMed Luzzio CC, Waclawik AJ, Gallagher CL, Knechtle SJ. Iliac artery pseudoaneurysm following renal transplantation presenting as lumbosacral plexopathy. Transplantation. 1999;67(7):1077–8.CrossRefPubMed
7.
go back to reference Taghavi M, Fard AS, Mehrsai R, Shadman M, editors. Late onset anastomotic pseudoaneurysm of renal allograft artery: case report, diagnosis, and treatment. Transplantation proceedings. London: Elsevier; 2005. Taghavi M, Fard AS, Mehrsai R, Shadman M, editors. Late onset anastomotic pseudoaneurysm of renal allograft artery: case report, diagnosis, and treatment. Transplantation proceedings. London: Elsevier; 2005.
8.
go back to reference Reus M, Morales D, Vázquez V, Llorente S, Alonso J. Ultrasound-guided percutaneous thrombin injection for treatment of extrarenal pseudoaneurysm after renal transplantation. Transplantation. 2002;74(6):882–4.CrossRefPubMed Reus M, Morales D, Vázquez V, Llorente S, Alonso J. Ultrasound-guided percutaneous thrombin injection for treatment of extrarenal pseudoaneurysm after renal transplantation. Transplantation. 2002;74(6):882–4.CrossRefPubMed
9.
go back to reference Corwin MT, Fananapazir G, Chaudhari AJ. MR Angiography of renal transplant vasculature with ferumoxytol: comparison of high-resolution steady-state and first-pass acquisitions. Academic radiology. 2015. Corwin MT, Fananapazir G, Chaudhari AJ. MR Angiography of renal transplant vasculature with ferumoxytol: comparison of high-resolution steady-state and first-pass acquisitions. Academic radiology. 2015.
10.
go back to reference Orlic P, Vukas D, Drescik I, Ivancic A, Blecic G, Budiselic B et al., editors. Vascular complications after 725 kidney transplantations during 3 decades. Transplantation proceedings. London: Elsevier; 2003. Orlic P, Vukas D, Drescik I, Ivancic A, Blecic G, Budiselic B et al., editors. Vascular complications after 725 kidney transplantations during 3 decades. Transplantation proceedings. London: Elsevier; 2003.
11.
go back to reference Koo CK, Rodger S, Baxter GM. Extra-renal pseudoaneurysm: an uncommon complication following renal transplantation. Clin Radiol. 1999;54(11):755–8.CrossRefPubMed Koo CK, Rodger S, Baxter GM. Extra-renal pseudoaneurysm: an uncommon complication following renal transplantation. Clin Radiol. 1999;54(11):755–8.CrossRefPubMed
12.
go back to reference Asztalos L, Olvasztó S, Fedor R, Szabó L, Balázs G, Lukács G, editors. Renal artery aneurysm at the anastomosis after kidney transplantation. Transplantation proceedings. London: Elsevier; 2006. Asztalos L, Olvasztó S, Fedor R, Szabó L, Balázs G, Lukács G, editors. Renal artery aneurysm at the anastomosis after kidney transplantation. Transplantation proceedings. London: Elsevier; 2006.
13.
go back to reference Sharron JA, Esterl RM, Washburn WK, Abrahamian GA. Surgical treatment of an extrarenal pseudoaneurysm after kidney transplantation. Vasc Endovascular Surg. 2009;43:317–21.CrossRefPubMed Sharron JA, Esterl RM, Washburn WK, Abrahamian GA. Surgical treatment of an extrarenal pseudoaneurysm after kidney transplantation. Vasc Endovascular Surg. 2009;43:317–21.CrossRefPubMed
14.
go back to reference Zavos G, Pappas P, Kakisis J, Leonardou P, Manoli E, Bokos J et al., editors. Endovascular repair as first-choice treatment of iliac pseudoaneurysms following renal transplantation. Transplantation proceedings. London: Elsevier; 2005. Zavos G, Pappas P, Kakisis J, Leonardou P, Manoli E, Bokos J et al., editors. Endovascular repair as first-choice treatment of iliac pseudoaneurysms following renal transplantation. Transplantation proceedings. London: Elsevier; 2005.
15.
go back to reference McIntosh BC, Bakhos CT, Sweeney TF, DeNatale RW, Ferneini AM. Endovascular repair of transplant nephrectomy external iliac artery pseudoaneurysm. Conn Med. 2005;69(8):465–6.PubMed McIntosh BC, Bakhos CT, Sweeney TF, DeNatale RW, Ferneini AM. Endovascular repair of transplant nephrectomy external iliac artery pseudoaneurysm. Conn Med. 2005;69(8):465–6.PubMed
16.
go back to reference Freyrie A, Rossi C, Cirelli M, Tedesco A, Leone M, Gaiani S, et al. Endovascular treatment of a false aneurysm in the site of nephrectomy of a transplanted kidney. G It Chir Vasc. 1999;6:135–8. Freyrie A, Rossi C, Cirelli M, Tedesco A, Leone M, Gaiani S, et al. Endovascular treatment of a false aneurysm in the site of nephrectomy of a transplanted kidney. G It Chir Vasc. 1999;6:135–8.
17.
go back to reference Diller R, Hölzen J, Senninger N, Kramer S, editors. Interventional stenting for ruptured iliac aneurysm following transplant nephrectomy. Transplantation proceedings. London: Elsevier; 2006. Diller R, Hölzen J, Senninger N, Kramer S, editors. Interventional stenting for ruptured iliac aneurysm following transplant nephrectomy. Transplantation proceedings. London: Elsevier; 2006.
18.
go back to reference Poels JA, Riley PL. Extrarenal transplant artery pseudoaneurysm: a combined therapeutic approach. Cardiovasc Intervent Radiol. 2008;31(2):404–6.CrossRefPubMed Poels JA, Riley PL. Extrarenal transplant artery pseudoaneurysm: a combined therapeutic approach. Cardiovasc Intervent Radiol. 2008;31(2):404–6.CrossRefPubMed
19.
go back to reference Liapis CD, Petrikkos GL, Paraskevas KI, Skiada A, Nikolaou AC, Tzortzis G, et al. External iliac artery stent mucormycosis in a renal transplant patient. Ann Vasc Surg. 2006;20(2):253–7.CrossRefPubMed Liapis CD, Petrikkos GL, Paraskevas KI, Skiada A, Nikolaou AC, Tzortzis G, et al. External iliac artery stent mucormycosis in a renal transplant patient. Ann Vasc Surg. 2006;20(2):253–7.CrossRefPubMed
20.
go back to reference Sanada J, Matsui O, Arakawa F, Tawara M, Endo T, Ito H, et al. Endovascular stent-grafting for infected iliac artery pseudoaneurysms. Cardiovasc Intervent Radiol. 2005;28(1):83–6.CrossRefPubMed Sanada J, Matsui O, Arakawa F, Tawara M, Endo T, Ito H, et al. Endovascular stent-grafting for infected iliac artery pseudoaneurysms. Cardiovasc Intervent Radiol. 2005;28(1):83–6.CrossRefPubMed
21.
go back to reference Kan C-D, Lee H-L, Yang Y-J. Outcome after endovascular stent graft treatment for mycotic aortic aneurysm: a systematic review. J Vasc Surg. 2007;46(5):906–12.CrossRefPubMed Kan C-D, Lee H-L, Yang Y-J. Outcome after endovascular stent graft treatment for mycotic aortic aneurysm: a systematic review. J Vasc Surg. 2007;46(5):906–12.CrossRefPubMed
Metadata
Title
Diagnosis and Management of Transplanted Kidney Extrarenal Pseudoaneurysms: A Series of Four Cases and a Review of the Literature
Authors
Ghaneh Fananapazir
Gemmy Hannsun
Luke A. Wright
Michael T. Corwin
Christoph Troppmann
Publication date
01-11-2016
Publisher
Springer US
Published in
CardioVascular and Interventional Radiology / Issue 11/2016
Print ISSN: 0174-1551
Electronic ISSN: 1432-086X
DOI
https://doi.org/10.1007/s00270-016-1425-z

Other articles of this Issue 11/2016

CardioVascular and Interventional Radiology 11/2016 Go to the issue