体外血管再建・自家腎移植を施行した腎動脈瘤の1例

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74歳男.高血圧の精査のための,腹部CT検査で左腎動脈の腫瘤(RAA)が偶然発見された.腫瘤径は25mmであり,石灰化所見はなかった.選択的血管造影検査と3D-CTでは,左腎動脈内に嚢状腎動脈瘤を認めた.術中破裂を危惧し,動脈瘤を含めて左腎を摘出後に血管を再建し,自家腎移植術を施行した.術後の3D-CTでは腎動静脈の狭窄やねじれは認めなかった.術後18ヵ月,経過良好であるA 74-year male patient was admitted to our department with a left renal artery aneurysm (RAA). It was detected by a computed tomography (CT) scan while performing an examination for hypertension. The diameter of the aneurysm was 25 mm. There was no evidence of calcification. Selective left renal angiography and a 3-dimensional (3D)-CT image revealed a saccular renal aneurysm in the left main renal artery. Because of the risk of rupture, autotransplantation of the left kidney to the left iliac fossa was performed after resecting the aneurysm and reconstructing the left artery under bench surgery. Postoperative 3D-CT revealed no stenosis. This ex-vivo technique and autotransplantation into ipsilateral iliac fossa are both effective and safe for the treatment of RAA.