Iliac - renal bypass in evar of AAA with renal arteries arissing from aneurysmal sac

[Graft-renal bypass surgery during intraoperative dissection of renal artery in a patient with high occlusion of the aorta]

Despite advances in the development of endovascular techniques of revascularization of renal arteries, in certain clinical cases still remains the need to perform extra-anatomic renal bypass grafting. To such instances belong complicated atherosclerotic aortic lesions, technical difficulties occurring during open revascularization of the aorta and its branches, as well as aneurysms of the juxtarenal portion of the abdominal aorta. Presented herein is a clinical case concerning a patient subjected to non-standard restoration of blood flow in the right renal artery after thromboendarterectomy from the juxtarenal aorta, performed from the left-sided extraperitoneal phrenolumbotomic approach and complicated by secondary dissection of the intima in the right renal artery.

Treatment possibility for AAA of the visceral branches region

The authors describe a promising abdominal aortic aneurysm treatment--a combined endovascular/surgical approach--used in two cases of aneurysm taking the aortic visceral branches region.