transplantologiyaТрансплантологияTransplantologiya. The Russian Journal of Transplantation2074-05062542-0909IPO Association of Transplantologists10.23873/2074-0506-2020-12-4-311-318transplantologiya-536Research ArticleКЛИНИЧЕСКИЕ НАБЛЮДЕНИЯCASE REPORTSИспользование стент-графта для эндоваскулярного лечения ложной аневризмы, возникшей после нефрэктомии трансплантатаEndovascular treatment of the pseudoaneurysm using stent-graft after transplant nephrectomyhttps://orcid.org/0000-0002-9680-9722ПрозоровС. А.ProzorovS. A.

Сергей Анатольевич Прозоров, д-р мед. наук, ведущий научный сотрудник отделения лучевой диагностики 

129090, Москва, Большая Сухаревская пл., д. 3

Sergey A. Prozorov - Dr. Sci. (Med.), Leading Researcher of the Radiology Department

3 Bolshaya Sukharevskaya Sq., Moscow 129090

surgeonserge@mail.ruГБУЗ «НИИ скорой помощи им. Н.В. Склифосовского ДЗМ»РоссияN.V. Sklifosovsky Research Institute for Emergency MedicineRussian Federation202011122020124311318Copyright © Прозоров С.А., 20202020Прозоров С.А.Prozorov S.A.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.jtransplantologiya.ru/jour/article/view/536

Введение. Сосудистые осложнения после нефрэктомии трансплантата бывают редко. Цель сообщения – анализ эффективности имплантации стент-графта при лечении ложной аневризмы, возникшей после нефрэктомии трансплантата. Клинический случай. Мужчине 50 лет за последние 23 года были выполнены три трансплантации трупной почки и два удаления трансплантата. Через 12 лет после последней нефрэктомии трансплантата он поступил с жалобами на боли в животе и наличием пульсирующего образования в левой подвздошной области. Проведенные компьютерная томографическая ангиография, ультразвуковое исследование и ангиография показали наличие ложной аневризмы левой наружной подвздошной артерии. Имплантация стент-графта позволила решить возникшую проблему с хорошими клиническим и ангиографическим результатами. Заключение. Лечение в таких случаях возможно как при открытой операции, так и с использованием эндоваскулярных методов. Хирургический метод сопровождается высоким риском осложнений, тогда как эндоваскулярное лечение имеет преимущество минимально инвазивного метода с низкой кровопотерей.

Introduction. Vascular complications after transplant nephrectomy are rather rare. The aim of this article is to analyze the effectiveness of the stent-graft implantation in the treatment of pseudoaneurysm after transplant nephrectomy. Clinical case. In the previous 23 years, a 50-year-old patient underwent 3 kidney transplantations from a cadaveric donor and 2 transplant nephrectomies. At 12 years after the left transplant nephrectomy he complained of abdominal pain and was admitted for a pulsating mass in his left pelvic region. Computed tomography angiography, ultrasonography, and arteriography were performed and showed a large pseudoaneurysm arising from the left external iliac artery. The stentgraft implantation solved the problem providing successful clinical and radiological results. Conclusion. Treatment options in this case were open or endovascular techniques. Surgical revision associated with high risk of complications. Endovascular treatment had the benefits of a minimally invasive approach with low blood loss.

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The authors declare that there are no conflicts of interest present.