Frontiers in Surgery (May 2022)
Innovative Technical Solution Using the Renal Artery Stump after Nephrectomy as an Inflow Artery for Lower Limb Revascularization—A Case Report
Abstract
We present the case of a 56-year-old patient admitted to the vascular unit of the Targu Mures County Emergency Clinical Hospital after a computed tomography angiography performed for critical limb ischemia showed a tumor of the right kidney of 11.3/12/11 cm anteroposterior/later-lateral/craniocaudal, accompanied by an abdominal aortic aneurysm (AAA) (3 cm diameter) and right iliac artery occlusion. An interdisciplinary team formed of urological and vascular surgeons decided and performed a one-step operation. The right kidney was removed, and the limb revascularization was achieved by performing a bypass that used the right renal arterial stump as an inflow artery, thus called a reno-femoral bypass. The AAA had no indication for reconstruction. The final pathology interpretation of the kidney tumor revealed a clear cell renal cell carcinoma, excised with oncological safety margins. A short-term follow-up found the patient without ischemic symptomatology and a fully functional graft.
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