Marie Y, Kumar A, Hinchliffe S, Curran S, Brown P, Turner D, Shrestha B. Treatment of transplant renal artery pseudoaneurysm using expandable hydrogel coils: A case report and review of literature. World J Transplantation 2018; 8(6): 232-236 [PMID: 30370233 DOI: 10.5500/wjt.v8.i6.232]
Corresponding Author of This Article
Badri Shrestha, MD MS MPhil FRCS (Eng, Edin and Gen), FACS, FEBS Consultant Transplant Surgeon, Sheffield Kidney Institute, Sheffield Teaching Hospitals NHS Foundation Trust, Herries Road, Sheffield S5 7AU, United Kingdom. shresthabm@doctors.net.uk
Research Domain of This Article
Transplantation
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Transplantation. Oct 22, 2018; 8(6): 232-236 Published online Oct 22, 2018. doi: 10.5500/wjt.v8.i6.232
Treatment of transplant renal artery pseudoaneurysm using expandable hydrogel coils: A case report and review of literature
Yazin Marie, Avneesh Kumar, Sarah Hinchliffe, Simon Curran, Peter Brown, Douglas Turner, Badri Shrestha
Yazin Marie, Avneesh Kumar, Sarah Hinchliffe, Simon Curran, Badri Shrestha, Sheffield Kidney Institute, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield S5 7AU, United Kingdom
Peter Brown, Douglas Turner, Radiology Department, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield S5 7AU, United Kingdom
Author contributions: Marie Y and Shrestha B managed the patient and prepared the manuscript; Kumar A, Hinchliffe S and Curran S were involved in managing the patient and contributed to manuscript preparation; Brown P and Turner D performed radiological investigations, managed the patient and contributed to manuscript preparation.
Informed consent statement: The patient involved in this study gave his written informed consent authorizing use and disclosure of her protected health information.
Conflict-of-interest statement: All authors have no conflicts of interests to declare.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Badri Shrestha, MD MS MPhil FRCS (Eng, Edin and Gen), FACS, FEBS Consultant Transplant Surgeon, Sheffield Kidney Institute, Sheffield Teaching Hospitals NHS Foundation Trust, Herries Road, Sheffield S5 7AU, United Kingdom. shresthabm@doctors.net.uk
Telephone: +44-11-42434343 Fax: +44-11-42714604
Received: March 9, 2018 Peer-review started: March 11, 2018 First decision: March 30, 2018 Revised: April 28, 2018 Accepted: October 8, 2018 Article in press: October 8, 2018 Published online: October 22, 2018 Processing time: 223 Days and 13.8 Hours
ARTICLE HIGHLIGHTS
Case characteristics
A 38-year-old male, who had received a deceased donor renal transplant presented with deterioration of renal function five months post-transplantation.
Clinical diagnosis
On examination, there were clinical features pointing to definitive diagnosis.
Differential diagnosis
Differential diagnosis included obstructive uropathy, acute rejection, infections, drug nephrotoxicity and transplant renal artery stenosis.
Laboratory diagnosis
The serum creatinine was significantly elevated.
Imaging diagnosis
The Duplex ultrasound scan showed reduced resistive index with high velocity flow in the renal artery suggestive of transplant renal artery stenosis. A computerized tomography angiogram showed a 20 mm × 25 mm pseudoaneurysm at the anastomosis site and stenosis of the transplant renal artery adjacent to the pseudoaneurysm.
Treatment
Endovascular embolisation of the pseudoaneurysm using expandable hydrogel coils (EHC) followed by deployment of stent lead to resolution of the pseudoaneurysm and transplant renal artery stenosis and restoration of renal function to normality.
Related reports
Follow-up of the patient was satisfactory with no adverse events related to the procedure.
Experiences and lessons
This is the first reported case of treatment of a transplant renal artery pseudoaneurysm with wide neck with the use of EHC leading to successful outcomes.
