A Novel Hybrid Approach to Manage Mycotic Pseudoaneurysm Post-Renal Transplantation: Successful Graft Preservation

A Novel Hybrid Approach to Manage Mycotic Pseudoaneurysm Post-Renal Transplantation: Successful Graft Preservation

<i>Background and Objectives</i>: Post-transplant anastomotic pseudoaneurysms are a rare but serious complication of renal transplantation, typically requiring graft sacrifice. This case report demonstrates a novel hybrid approach for managing a mycotic pseudoaneurysm while preserving gr...

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Main Authors: Ho Li, Yi-Chang Lin, Chien-Chang Kao, Pei-Jhang Chiang, Meng-Han Chou, Hui-Kung Ting, Yu-Cing Jhuo, Ming-Hsin Yang, Chih-Wei Tsao, En Meng, Guang-Huan Sun, Dah-Shyong Yu, Sun-Yran Chang, Chin-Li Chen, Sheng-Tang Wu
Format: Article
Language:English
Published: MDPI AG 2025-03-01
Series:Medicina
Subjects:
renal transplantation
post-transplant pseudoaneurysm
endovascular intervention
femoral-femoral bypass
graft preservation
percutaneous transluminal angioplasty
Online Access:https://www.mdpi.com/1648-9144/61/3/521
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Summary:<i>Background and Objectives</i>: Post-transplant anastomotic pseudoaneurysms are a rare but serious complication of renal transplantation, typically requiring graft sacrifice. This case report demonstrates a novel hybrid approach for managing a mycotic pseudoaneurysm while preserving graft function. <i>Case report:</i> A 56-year-old male developed a pseudoaneurysm at the anastomotic site after cadaveric kidney transplantation, presenting with recurrent infections and declining renal function. Imaging confirmed the pseudoaneurysm. A hybrid strategy combining femoral–femoral bypass with a polytetrafluoroethylene graft, percutaneous transluminal angioplasty with stenting, and coil embolization was performed. <i>Results</i>: The intervention successfully isolated the pseudoaneurysm and preserved graft function. Post-procedure, serum creatinine levels improved, stabilizing at 2.3 mg/dL during follow-up. Imaging confirmed no residual flow in the aneurysm, and vascular complications were absent. <i>Conclusions</i>: This report highlights a successful combined surgical and endovascular approach for treating mycotic pseudoaneurysms, preserving graft function and restoring limb blood flow. This strategy offers a promising alternative for managing complex post-transplant complications, though long-term outcomes require further evaluation.
ISSN:1010-660X
1648-9144

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