Abdominal and Iliac Arterial Aneurysms Associated with a Horseshoe Kidney. Should Aberrant Vascular Anatomy Mandate the Treatment Modality?

Abstract

We report a case of a patient with the symptomatic abdominal aortic and iliac arterial aneurysms associated with the horseshoe kidney. The preoperative contrast-enhanced helical CT demonstrated two normal main renal arteries and one large accessory renal artery originating from the anterior surface of the aortic aneurysm and supplying most of the renal isthmus. Open surgical reconstruction was performed using a bifurcated polyester graft. The important accessory renal artery was included within the beveled proximal anastomosis. Fifteen months after the operation the patient was asymptomatic and his renal function was normal. The impact of the accessory renal arteries on decision making regarding treatment modality is discussed.