Open surgical repair for a ruptured abdominal aortic aneurysm with a horseshoe kidney

Open surgical repair of abdominal aortic aneurysm and horseshoe kidney: A strange relationship

Introduction and importance

The horseshoe kidney (HK) is the most common fusion defect of the kidneys. Τhe simultaneous presence of HK and abdominal aortic aneurysm (ΑΑΑ) is rare and comprises a technical challenge for the vascular surgeon due to variation of renal arteries and the renal isthmus overlying the AAA sac.

Case presentation

We present the first case in Nicosia General Hospital of Cyprus of an infrarenal AAA with a HK (Crawford Type I), which was successfully treated using an open surgical approach.

Clinical discussion

Review the technical challenges associated with the case and a brief reference to the relevant published articles.

Conclusion

The surgical repair of coexistence of AAA and HK continues to be a difficult technical challenge for the vascular surgeon from the past until today. There is a need to record the few cases and to create detailed specific guidelines to facilitate the surgical approach for the disease.

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Τhe simultaneous presence of HK and abdominal aortic aneurysm (ΑΑΑ) is rare.

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It comprises a technical challenge for the vascular surgeon.

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First case in Cyprus of an infrarenal AAA with a HK.

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The preoperative planning for the coexistence of the HK and AAA is important and useful.

Hybrid Repair of an Abdominal Aortic Aneurysm: Debranching with Endovascular Aneurysm Repair in a Patient with Horseshoe Kidney

Abdominal aortic aneurysm (AAA) with associated horseshoe kidney (HSK) poses a technical challenge when performing conventional open surgical repair because of possible complications including renal infarction, neuralgia, and collecting system disruption. Endovascular aortic repair (EVAR) is considered the first-line treatment for this pathology, allowing for aneurysm repair without isthmus bisection. However, whether to sacrifice commonly presenting aberrant renal arteries during EVAR is a point of controversy. We report a case in which hybrid repair was performed for AAA to preserve aberrant renal vasculature in a patient with HSK.

Surgical Treatment of a Voluminous Infrarenal Abdominal Aortic Aneurysm with Horseshoe Kidney: Tips and Tricks

Horseshoe kidney is a common urology anomaly, while its association with infrarenal abdominal aortic aneurysm represents a very rare condition. Surgical approach remains controversial however, we believe that the left retroperitoneal approach should be preferred in order to avoid isthmus resection with any subsequent renal infarction, urinary tract damage and to facilitate renal arteries reimplantation, when required. We present a case of voluminous infrarenal abdominal aortic aneurysm associated with horseshoe kidney, successfully treated through a left retroperitoneal approach on the retro-renal space.