Aortobifemoral reconstruction and renal transplantation in a patient with abdominal aortic aneurysm and occlusion of iliac arteries: A case report

Aleksandar Tomić; Novak Milović; Ivan Marjanović; Ivan Leković; Zoran Bjelanović; Momir Šarac; Neven Vavić; Ljiljana Ignjatović; Dušica Stamenković; Saša Micković

doi:10.2298/VSP140609139T

Aleksandar Tomić Clinic for Vascular and Endovascular Surgery; Military Medical Academy, Belgrade, Serbia; Faculty of Medicine of the Military Medical Academy, University of Defence, Belgrade, Serbia
Novak Milović Clinic for Urology, §Clinic for Nephrology, Military Medical Academy, Belgrade, Serbia; Faculty of Medicine of the Military Medical Academy, University of Defence, Belgrade, Serbia
Ivan Marjanović Clinic for Vascular and Endovascular Surgery; Military Medical Academy, Belgrade, Serbia; Faculty of Medicine of the Military Medical Academy, University of Defence, Belgrade, Serbia
Ivan Leković Clinic for Vascular and Endovascular Surgery; Military Medical Academy, Belgrade, Serbia
Zoran Bjelanović Clinic for Vascular and Endovascular Surgery, Military Medical Academy, Belgrade, Serbia
Momir Šarac Clinic for Vascular and Endovascular Surgery, Military Medical Academy, Belgrade, Serbia
Neven Vavić Clinic for nephrology, Military Medical Academy, Belgrade, Serbia
Ljiljana Ignjatović Clinic for nephrology, Military Medical Academy, Belgrade, Serbia
Dušica Stamenković Clinic for Anesthesia and Intensive Care, Military Medical Academy, Belgrade, Serbia; Faculty of Medicine of the Military Medical Academy, University of Defence, Belgrade, Serbia
Saša Micković Clinic for vascular and endovascular surgery, Military Medical Academy, Belgrade, Serbia

DOI: https://doi.org/10.2298/VSP140609139T

Keywords: atherosclerosis, iliac artery, aortic aneurysm, abdominal, renal dialysis, comorbidity, vascular surgical procedures, kidney transplantation,

Abstract

Introduction. Aortoiliac occlusive disease and abdominal aortic aneurysm in patients with renal insufficiency on hemodialysis can significantly influence the success of renal transplantation. In the recent past, advanced atherosclerosis was considered as contraindication for renal transplantation. Complicated creation of vascular anastomoses and progression of occlusive or aneurysmal disease were the main reasons. Case report. We presented a 52-year-old man with a 5-year history of end-stage renal disease on haemodialysis. The patient was previously excluded from renal transplantation program because of severe aortoiliac atherosclerosis and abdominal aortic aneurysm. Resection of abdominal aortic aneurysm with occlusion of the iliac arteries and reconstruction with aortobifemoral synthetic grafts was performed and followed by cadaveric renal transplantation. Conclusion. Advanced atherosclerotic disease in aortoiliac segment requires elective vascular surgical reconstruction, as part of preparation for renal transplantation in patients with end-stage renal disease.

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