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Mozafar M, Zarrintan S, Tubbs RS. Simultaneous resection of abdominal aortic aneurysm and left renal cell carcinoma: A rare case and review of the literature. J Cardiovasc Thorac Res 2020; 12:152-155. [PMID: 32626558 PMCID: PMC7321004 DOI: 10.34172/jcvtr.2020.26] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2019] [Accepted: 12/04/2019] [Indexed: 01/01/2023] Open
Abstract
We report a rare case of concomitant abdominal aortic aneurysm (AAA) and left renal cell carcinoma (RCC). The patient was an 81-year old man who presented with vague abdominal pain. The investigations revealed a 110*73*62 mm AAA together with 69*56 left renal mass. Open repair of AAA with left radical nephrectomy was conducted. A simultaneous procedure is safe and does not increase morbidity and mortality in selected cases.
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Affiliation(s)
- Mohammad Mozafar
- Division of Vascular & Endovascular Surgery, Department of General & Vascular Surgery, Shohada-Tajrish Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Sina Zarrintan
- Division of Vascular & Endovascular Surgery, Department of General & Vascular Surgery, Shohada-Tajrish Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - R Shane Tubbs
- Department of Neurosurgery, Tulane University School of Medicine, New Orleans, LA, USA.,Department of Structural & Cellular Biology, Tulane University School of Medicine, New Orleans, LA, USA.,Department of Anatomical Sciences, St. George's University, Grenada
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Management and therapeutic options for abdominal aortic aneurysm coexistent with horseshoe kidney. J Vasc Surg 2019; 69:1257-1267. [DOI: 10.1016/j.jvs.2018.10.009] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2018] [Accepted: 10/02/2018] [Indexed: 10/27/2022]
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Davidovic LB, Markovic M, Kostic D, Zlatanovic P, Mutavdzic P, Cvetic V. Open repair of ruptured abdominal aortic aneurysm with associated horseshoe kidney. INT ANGIOL 2018; 37:471-478. [DOI: 10.23736/s0392-9590.18.04039-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Göksel O, Cinar B, Kömürcü G, Ahin S, Eren T. Surgical Treatment of Abdominal Aortic Aneurysms Associated with Horseshoe Kidney. Vascular 2016; 14:27-31. [PMID: 16849020 DOI: 10.2310/6670.2006.00002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Abdominal aortic aneurysm surgery associated with a horseshoe kidney (HSK) is a serious technical challenge for the surgeon. We reviewed our experience with 127 patients electively operated on between 1990 and 2004 for abdominal aortic aneurysm. Pre- and perioperative medical, surgical, and radiologic data were retrospectively reviewed. Preoperative diagnosis was achieved with computed tomography with or without angiography or with additional conventional aortography. Seven patients were recognized to have had a HSK, with a mean age of 67.29 ± 2.43 years. Preoperative serum creatinine levels were similar in patients with or without HSK (1.0 ± 0.08 vs 0.9 ± 0.12 mg/dL; not significant). In five of the patients with HSK, reimplantation of the anomalous renal artery was necessary. In all 127 patients, hospital mortality consisted of 5 patients, none of whom had an HSK. Dealing with HSK seemed to increase aortic clamp times (30.43 ± 3.55 vs 27.04 ± 3.92 minutes; p < .05) slightly. Patients with or without HSK were given similar amounts of intravenous fluid replacement (2,214.2 ± 441.3 vs 1,923.3 ± 433.6 mL/patient; not significant) and allogeneic blood transfusion (0.71 ± 0.49 vs 0.9 ± 0.4 U/patient; not significant) and had a similar intensive care unit stay. Abdominal aortic aneurysms associated with HSK have been managed without division of the isthmic tissue. The left retroperitoneal approach provided adequate exposure for all patients with HSK.
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Affiliation(s)
- Onur Göksel
- Department of Cardiovascular Surgery, Istanbul Medical Faculty, University of Istanbul, Istanbul, Turkey.
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Rey J, Golpanian S, Yang JK, Moreno E, Velazquez OC, Goldstein LJ, Chahwala V. Extra-anatomic Endovascular Repair of an Abdominal Aortic Aneurysm with a Horseshoe Kidney Supplied by the Aneurysmal Aorta. Ann Vasc Surg 2015; 29:1021.e9-1021.e12. [DOI: 10.1016/j.avsg.2015.01.020] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2014] [Revised: 01/14/2015] [Accepted: 01/23/2015] [Indexed: 10/23/2022]
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Chan YC, Qing KX, Ting AC, Cheng SW. Endovascular infrarenal aneurysm repair in patients with horseshoe kidneys: case series and literature review. Vascular 2011; 19:126-31. [DOI: 10.1258/vasc.2010.cr0256] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Horseshoe kidney may cause technical and access problems during open aortic aneurysm repair. The aim of this study is to report two cases from our institution and to review the world's literature on successful endovascular infrarenal aneurysm repair in patients with horseshoe kidneys. A retrospective review of a prospectively entered departmental computerized database was performed for the two patients from our institution. Articles were searched electronically from PubMed and Medline, using the terms ‘horseshoe kidney’ and ‘aneurysm’. Endovascular cases were reviewed from the world's literature. In addition to the two patients from our institution, there were 19 patients with infrarenal aneurysms and horseshoe kidneys in published literature who underwent successful endovascular aneurysm repair. The occlusion of lower-pole or accessory renal arteries does not seem to cause significant endoleak or renal impairment in the long run. In conclusion, our experience and current literature seem to suggest that endovascular repair of infrarenal aortic aneurysms for patients with horseshoe kidneys is safe. Renal impairment will depend on the area of kidney perfused by the accessory renal arteries. The endovascular treatment option is less invasive than open repair, and circumvents the problem of difficult exposure, especially in those patients with significant co-morbidity.
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Affiliation(s)
- Y C Chan
- Division of Vascular & Endovascular Surgery, Department of Surgery, University of Hong Kong Medical Centre, South Wing, 14th Floor K Block, Queen Mary Hospital, Pokfulam Road, Hong Kong
| | - K X Qing
- Division of Vascular & Endovascular Surgery, Department of Surgery, University of Hong Kong Medical Centre, South Wing, 14th Floor K Block, Queen Mary Hospital, Pokfulam Road, Hong Kong
| | - A C Ting
- Division of Vascular & Endovascular Surgery, Department of Surgery, University of Hong Kong Medical Centre, South Wing, 14th Floor K Block, Queen Mary Hospital, Pokfulam Road, Hong Kong
| | - S W Cheng
- Division of Vascular & Endovascular Surgery, Department of Surgery, University of Hong Kong Medical Centre, South Wing, 14th Floor K Block, Queen Mary Hospital, Pokfulam Road, Hong Kong
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Chaudhuri A. Exclusion of an Infrarenal AAA with Coincident Horseshoe Kidney and Renovascular Anomalies is Feasible Using a Standard Stent-graft. Eur J Vasc Endovasc Surg 2011; 41:654-6. [DOI: 10.1016/j.ejvs.2011.02.011] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2010] [Accepted: 02/07/2011] [Indexed: 11/29/2022]
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