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Published in: Journal of Medical Case Reports 1/2021

Open Access 01-12-2021 | Kidney Transplantation | Case report

Endovascular management of giant common iliac artery pseudoaneurysm after complications in simultaneous pancreas–kidney transplant: a case report

Authors: Túlio Fabiano de Oliveira Leite, Lucas Vatanabe Pazinato, Thiago Franchi Nunes, Joaquim Mauricio da Motta Leal Filho

Published in: Journal of Medical Case Reports | Issue 1/2021

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Abstract

Background

Pancreatic transplantation is a definitive treatment for selected patients with insulin-dependent diabetes. It is a technically challenging surgery, and vascular complications are the most common cause of pancreatic graft failure. Although rare, pancreas transplants present higher rates of pseudoaneurysms at the vascular anastomosis than other visceral transplants. We present a case of a simultaneous pancreas–kidney transplant complicated with graft failure and common iliac artery pseudoaneurysm that was successfully treated through endovascular techniques.

Case presentation

A 34-year-old White woman presented with abdominal pain and a history of type 1 diabetes mellitus, end-stage renal disease, and two previous pancreas transplantation failures. The first was a simultaneous pancreas–kidney transplantation performed 7 months prior that was complicated by pancreas graft thrombosis within 1 month and required graft resection. Five months later, she underwent a second pancreas transplantation with another pancreatic graft thrombosis requiring graft resection. Abdominal angiotomography revealed a pseudoaneurysm in the right common iliac artery at the point of the previous graft anastomosis. The patient was successfully treated endovascularly with a covered stent in the common iliac artery.

Conclusion

Stent graft implantation for the treatment of common iliac artery pseudoaneurysm as a complication of simultaneous pancreas–kidney transplantation is a safe and feasible procedure.
Literature
1.
go back to reference Lubezky N, Goykhman Y, Nakache R, Kessler A, Baruch R, Katz P, Kori I, Klausner JM, Ben-Haim M. Early and late presentations of graft arterial pseudoaneurysm following pancreatic transplantation. World J Surg. 2013;37(6):1430–7.CrossRef Lubezky N, Goykhman Y, Nakache R, Kessler A, Baruch R, Katz P, Kori I, Klausner JM, Ben-Haim M. Early and late presentations of graft arterial pseudoaneurysm following pancreatic transplantation. World J Surg. 2013;37(6):1430–7.CrossRef
2.
go back to reference Arantes RM, Pantanali CAR, Santos VR, D’Albuquerque LAC. Arterial pseudoaneurysm associated with pancreas and kidney transplantation: a case report. Am J Case Rep. 2017;18:198.CrossRef Arantes RM, Pantanali CAR, Santos VR, D’Albuquerque LAC. Arterial pseudoaneurysm associated with pancreas and kidney transplantation: a case report. Am J Case Rep. 2017;18:198.CrossRef
3.
go back to reference Mafeld S, Logue JA, Masson S, Thakkar R, Amer A, Wilson C, Sem G, Manas D, White S, Williams R. Treatment of visceral transplant pseudoaneurysms using physician-modified fenestrated stent grafts: initial experience. Cardiovasc Intervent Radiol. 2019;42(6):920–6.CrossRef Mafeld S, Logue JA, Masson S, Thakkar R, Amer A, Wilson C, Sem G, Manas D, White S, Williams R. Treatment of visceral transplant pseudoaneurysms using physician-modified fenestrated stent grafts: initial experience. Cardiovasc Intervent Radiol. 2019;42(6):920–6.CrossRef
4.
go back to reference França M, Certo M, Martins L, Varzim P, Teixeira M, Henriques A, Ribeiro A, Alves F. Imaging of pancreas transplantation and its complications. Insights Imaging. 2010;1:329–38.CrossRef França M, Certo M, Martins L, Varzim P, Teixeira M, Henriques A, Ribeiro A, Alves F. Imaging of pancreas transplantation and its complications. Insights Imaging. 2010;1:329–38.CrossRef
5.
go back to reference Ibáñez JM, Robledo AB, López-Andujar R. Late complications of pancreas transplant. World J Transplant. 2020;10(12):404.CrossRef Ibáñez JM, Robledo AB, López-Andujar R. Late complications of pancreas transplant. World J Transplant. 2020;10(12):404.CrossRef
7.
go back to reference de Oliveira Leite TF, Bortolini E, Linard B, Boueri BA, Carnevale FC, Nomura CH, da Motta Leal Filho JM. Evaluation of morphological and clinical factors related to failure of percutaneous treatment with thrombin injection of femoral pseudoaneurysms from cardiac catheterization. Ann Vasc Surg. 2019;59:173–83.CrossRef de Oliveira Leite TF, Bortolini E, Linard B, Boueri BA, Carnevale FC, Nomura CH, da Motta Leal Filho JM. Evaluation of morphological and clinical factors related to failure of percutaneous treatment with thrombin injection of femoral pseudoaneurysms from cardiac catheterization. Ann Vasc Surg. 2019;59:173–83.CrossRef
8.
go back to reference Young SJ, Bergren L, Dunn T, Shrestha P, Yadav K, Frank N, Kandaswamy R, Golzarian J. Outcomes of endovascular management of late vascular hemorrhage after pancreatic transplant. Am J Roentgenol. 2018;210(1):201–6.CrossRef Young SJ, Bergren L, Dunn T, Shrestha P, Yadav K, Frank N, Kandaswamy R, Golzarian J. Outcomes of endovascular management of late vascular hemorrhage after pancreatic transplant. Am J Roentgenol. 2018;210(1):201–6.CrossRef
Metadata
Title
Endovascular management of giant common iliac artery pseudoaneurysm after complications in simultaneous pancreas–kidney transplant: a case report
Authors
Túlio Fabiano de Oliveira Leite
Lucas Vatanabe Pazinato
Thiago Franchi Nunes
Joaquim Mauricio da Motta Leal Filho
Publication date
01-12-2021

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