Chimney technique for a solitary pelvic kidney

Area of Science:

• Vascular Surgery
• Nephrology
• Anatomical Variations

Background:

• Abdominal aortic aneurysms (AAAs) pose significant surgical challenges.
• Solitary pelvic kidneys are rare congenital anomalies.
• Managing AAA in patients with ectopic pelvic kidneys requires tailored endovascular strategies.

Observation:

• A 63-year-old male presented with an incidentally discovered fusiform AAA.
• Preoperative imaging revealed a solitary ectopic kidney in the pelvis with an aberrant renal artery.
• This anatomical configuration presented a complex scenario for standard AAA repair.

Findings:

• A bifurcated endograft was successfully implanted for the AAA.
• The chimney technique was employed to place a covered stent graft into the aberrant renal artery.
• Postoperative scans confirmed excellent patency of the chimney graft at early and one-month follow-up.

Implications:

• This case demonstrates the feasibility and effectiveness of the chimney graft technique in managing AAA with a solitary pelvic kidney.
• It offers a potential solution for complex aortic pathologies in patients with rare anatomical variations.
• This approach may improve outcomes for patients with challenging renal artery anatomy during endovascular aneurysm repair.