The occurrence of aortoiliac lesions with renal transplantation is an increasingly common combination that causes problems regarding operative strategy and indications for aortoiliac reconstruction and renal transplantation. Staged or simultaneous surgical repair of aortoiliac lesions with renal transplantation is possible at reasonable risk. Renal transplantation after repair of aortoiliac occlusive disease with traditional prosthetic vascular grafts has been shown to be effective. Interventional radiology continues to rapidly evolve, most notably with the advancement of PTA/stent placement of aortoiliac lesions. Trials continue to support the trend toward the use of endovascular aortic stent grafts in patients with TASC type A, B, C and D aortoiliac lesions. Literature data are still scarce regarding renal transplantation after endovascular stent placement of TASC type B aortoiliac lesions. Herein, we describe the first renal transplant in a patient with disabling claudication and TASC type B aortoiliac disease which treated with an endovascular aortoiliac stent graft (figure 1). ABI (ankle-brachial index) before and after the stent placement were 0.6 vs. 1.2 respectively. No intraoperative difficulties were encountered. At 1 year follow-up, the transplanted kidney is functioning well with a normal serum creatinine level of 1.2 mg/dl, and the patient has no worsening of peripheral vascular disease with ABI 1.28 (figure 2). We recommend that percutaneous intervention can be recommended for patients with TASC type B aortoiliac disease and the presence of an endovascular aortoiliac stent not be a contraindication to perform a renal transplantation.
Volume : 6
Issue : 4
Pages : 130
Department of Surgery, Yeditepe University Hospital, Istanbul, Turkey