Endovascular Repair of Large Iliac Artery Pseudoaneurysm after Remote Transplant Nephrectomy

This case study focuses on a 49-year-old woman several years after a right transplant nephrectomy for delayed renal hemorrhage. The patient had an incidental finding of a right external iliac artery pseudoaneurysm measuring 8.1 cm at its largest dimension. Of note, the patient had undergone cardiac catheterization several months prior with right common femoral artery access. This study aimed to implement endovascular repair of posttransplant nephrectomy iliac artery pseudoaneurysms as a less invasive treatment option as compared with open repair in suitable candidates. Percutaneous access of the right common femoral artery with the deployment of a 9 × 50 mm covered stent within the right external iliac artery with the successful exclusion of the pseudoaneurysm. Postoperative course was uncomplicated, and the patient was discharged home on dual antiplatelet therapy. The patient's symptoms completely resolved after the intervention. She underwent follow-up surveillance scans, which redemonstrated a patent external iliac stent and excluded pseudoaneurysm. Endovascular repair with a covered stent for posttransplant nephrectomy iliac artery pseudoaneurysms is a safe, minimally invasive, and valuable treatment option in the absence of underlying infection.