The therapeutic implications of an abdominal aortic aneurysm with coincident horseshoe kidney

Two male patients were admitted to the department of vascular surgery for treatment of a large infrarenal abdominal aortic aneurysm (AAA) and an associated horseshoe kidney (HSK). Both patients were successfully treated by endovascular aneurysm repair (EVAR). Horseshoe kidney is a rare and complex congenital anomaly, which increases significantly the technical difficulty of conventional surgical repair of an associated AAA. Appropriate preoperative evaluation of the vascular supply of the HSK by CT- angiography and renal function is mandatory for optimal planning of the treatment strategy. EVAR is regarded as a valuable alternative to open surgical therapy, in the absence of renal failure and provided that accessory renal arteries are absent or small.