Chimney technique for solitary pelvic kidney

Area of Science:

• Vascular Surgery
• Urology
• Medical Imaging

Background:

• The coexistence of abdominal aortic aneurysm (AAA) and a solitary pelvic kidney presents unique surgical challenges due to anatomical variations.
• Standard endovascular aneurysm repair (EVAR) may be complicated by the ectopic renal artery originating from the aneurysm sac.
• This scenario necessitates innovative endovascular approaches to preserve renal function.

Observation:

• A 63-year-old male patient was incidentally diagnosed with an infrarenal AAA.
• Preoperative imaging revealed a solitary ectopic kidney in the pelvis with an aberrant renal artery arising from the aneurysm.
• This anatomical anomaly posed a significant risk for standard EVAR.

Findings:

• A bifurcated endograft was successfully implanted for the AAA.
• The chimney technique was employed, utilizing a covered stent graft to cannulate the aberrant renal artery.
• Postoperative imaging confirmed excellent patency of the chimney graft at early and one-month follow-ups.

Implications:

• The chimney technique offers a viable solution for endovascular repair in complex AAA cases involving solitary pelvic kidneys.
• This approach may be crucial for preserving renal perfusion in patients with rare anatomical variations.
• Further research is warranted to evaluate the long-term outcomes of this technique in similar challenging cases.