• B Toursarkissian, A Mejia, M H Wholey, M A Lawler, I M Thompson, and M T Sykes.
• Department of Surgery, University of Texas Health Science Center at San Antonio, 78229, USA. toursarkiss@uthscsa.edu
• J. Endovasc. Ther. 2001 Dec 1; 8 (6): 604-8.

PurposeTo report the endovascular exclusion of an abdominal aortic aneurysm (AAA) in a patient with a horseshoe kidney and an isthmus mass with preservation of accessory renal vessels.Case ReportA 70-year-old man with a 5-cm AAA and renal cell carcinoma involving a horseshoe kidney was treated with an AneuRx bifurcated graft. Two accessory renal arteries believed to feed the isthmus mass were sacrificed, but 2 other accessory renal arteries from the left common iliac artery (CIA) were preserved by using an extension cuff to cover the aneurysmal left CIA distal to their origins. The right renal isthmus mass decreased in size on follow-up imaging. At 9 months, there was no endoleak evident on computed tomographic scans, and the aneurysm measured 4.8 cm.ConclusionsThe presence of accessory renal arteries in AAA patients with horseshoe kidneys should not automatically exclude them from consideration for endovascular repair. Creative stent-graft arrangements can be a treatment option.

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