Int J Angiol
DOI: 10.1055/s-0040-1709502
Case Report
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Renal Transplant Artery Inflow Stenosis Treated with Femorofemoral Bypass

Christopher Chiodo Ortiz*
1  Department of Surgery, Northwell Health, Manhasset, New York
,
Santiago J. Miyara*
1  Department of Surgery, Northwell Health, Manhasset, New York
2  Department of Emergency Medicine, Northwell Health, Manhasset, New York
3  Elmezzi Graduate School of Molecular Medicine, Manhasset, New York
,
Joaquin A. Cagliani
1  Department of Surgery, Northwell Health, Manhasset, New York
,
Young Min Cho
1  Department of Surgery, Northwell Health, Manhasset, New York
,
Sara Guevara
1  Department of Surgery, Northwell Health, Manhasset, New York
,
Kei Hayashida
2  Department of Emergency Medicine, Northwell Health, Manhasset, New York
,
Koichiro Shinozaki
2  Department of Emergency Medicine, Northwell Health, Manhasset, New York
,
Damian Clement
1  Department of Surgery, Northwell Health, Manhasset, New York
,
Lance B. Becker
2  Department of Emergency Medicine, Northwell Health, Manhasset, New York
3  Elmezzi Graduate School of Molecular Medicine, Manhasset, New York
,
Bo Wang
1  Department of Surgery, Northwell Health, Manhasset, New York
,
K.V. Krishnasastry
1  Department of Surgery, Northwell Health, Manhasset, New York
,
Lewis W. Teperman
1  Department of Surgery, Northwell Health, Manhasset, New York
,
Ernesto P. Molmenti
1  Department of Surgery, Northwell Health, Manhasset, New York
› Author Affiliations
Further Information

Publication History

Publication Date:
16 May 2020 (online)

Abstract

In this case report we describe a novel and successful revascularization approach in instances of allograft and distal limb ischemia after kidney transplantation. Stenosis proximal to transplant renal artery anastomoses is a complication leading to allograft dysfunction and/or loss. We present a femorofemoral bypass graft with ringed polytetrafluoroethylene (PTFE). In this occasion, revascularization was achieved by a backflow mechanism. The approach described achieved its goal of revascularizing the allograft as well as the distal extremity, with both short- and long-term successful outcomes. Benefits of this approach when compared with re-implantation or procedures directly involving the transplant renal artery include minimization of ischemic time, no need to repair the stenosis, anastomoses with vessels of greater diameter, no need to perfuse the kidney, no need to take down the renal artery anastomosis, no need to dissect the transplanted kidney, and no further lower extremity ischemia. This approach does not require any proximal temporary inflow occlusion (as seen with stent placement) or clamping of the arterial inflow to the kidney. This procedure was completed without having to infuse any preservation fluid into the kidney.

* Both the authors have equal contribution.