Abstract
Intraoperative fluorescent imaging using indocyanine green enables vascular surgeons to confirm the location and states of the reconstructed vessels during surgery. Complex renal artery aneurysm repair involving second order branch vessels has been performed with different techniques. We present a case of ex vivo repair and autotransplantation combining the advantages of minimally invasive surgery and indocyanine green enhanced fluorescence imaging to facilitate vascular anatomy recognition and visualization of organ reperfusion.
Highlights
Operative repair of renal artery aneurysm (RAA) may be accomplished by different techniques; endovascular stent-grafting or embolization procedures are attractive alternative for the RAAs treatment [1, 2]
Complex renal artery aneurysm repair involving second order branch vessels has been performed with different techniques
We present a case of ex vivo repair and autotransplantation combining the advantages of minimally invasive surgery and indocyanine green enhanced fluorescence imaging to facilitate vascular anatomy recognition and visualization of organ reperfusion
Summary
Operative repair of renal artery aneurysm (RAA) may be accomplished by different techniques; endovascular stent-grafting or embolization procedures are attractive alternative for the RAAs treatment [1, 2]. Intraoperative vascular quality control during renal transplantation is not performed on a routine basis, while duplex ultrasound evaluation of the organ perfusion is generally performed postoperatively [6]. A technical advancement has been recently introduced in general surgery, that is, the intraoperative use of fluorescent imaging using indocyanine green (ICG); this is an intriguing technique for easier intraoperative recognition of vascular anatomy and for evaluating organ perfusion that has been reported in kidney transplantation [6,7,8,9]. We report a case of a complex RAA treatment using laparoscopic nephrectomy, ex vivo aneurysmectomy, and autotransplantation with the intraoperative use of ICG fluorescent imaging to optimize the visualization of vascular anatomy and control the revascularization after vascular repair
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