J Korean Soc Vasc Surg.  2008 May;24(1):56-59.

Surgical Treatment of a Suprarenal Abdominal Aortic Pseudoaneurysm that Recurred 20 Years after Aorto-renal Bypass in a Patient with Takayasu Arteritis

• Park YJ
• Min SK
• Ha J
• Kim YS
• Kim SJ

Abstract

Takayasu arteritis (TA) is a chronic systemic inflammatory disease that most commonly affects the aorta and its major branches. TA-induced renal artery stenosis (TARAS) can result in malignant hypertension, severe renal dysfunction, cardiac decompression and premature death. Surgical management for TARAS has been proved to be effective and safe, especially in the medically or interventionally-intractable cases. We report here on a 39-year-old patient with recently deteriorating hypertension and renal function because of a recurred RAS, for which he underwent "y-shaped" aorto-birenal reconstruction surgery 20 years ago. CT angiography showed bilateral diffuse calcified stenosis in the previous renal graft and there was a partial rupture of a pseudoaneurysm in the suprarenal abdominal aorta segment between the celiac axis and the renal graft. We performed descending thoracic aorto-abdominal aortic bypass together with a graft-renal bypass and exclusion of the pseudoaneurysm. The renal function was normalized and the blood pressure became stable without any antihypertensive medication. He recovered and was discharged without any complications.

Keyword

Takayasu arteritis; renal artery atenosis; renovascular hypertension

MeSH Terms

Adult
Aneurysm, False
Angiography
Aorta
Aorta, Abdominal
Axis, Cervical Vertebra
Blood Pressure
Constriction, Pathologic
Decompression
Humans
Hypertension
Hypertension, Malignant
Hypertension, Renovascular
Mortality, Premature
Renal Artery Obstruction
Rupture
Takayasu Arteritis
Transplants