Intravascular Ultrasound (IVUS)-Assisted Fenestrated Endovascular Aortic Repair (FEVAR) for Iuxtarenal Aortic Aneurysm with Pelvic Ectopic Left Kidney and Aberrant Left Renal Arteries: A Case Report.
- 1Department of Surgery, Sapienza University of Rome, Viale Regina Elena, 324, 00161 Rome, Italy.
- 2Department of Interventional Cardiology, Sapienza University of Rome, Viale Regina Elena, 324, 00161 Rome, Italy.
- 3Department of Cardiac Surgery, Sapienza University of Rome, Viale Regina Elena, 324, 00161 Rome, Italy.
Abstract
Background and Clinical Significance: Complex abdominal aortic aneurysms (AAAc) involving visceral and renal vessels can be treated via open surgery or less invasive fenestrated endovascular aneurysm repair (FEVAR). Intravascular ultrasound (IVUS) minimizes contrast and radiation while improving placement accuracy, though its specific role in FEVAR remains understudied. This CARE-compliant article reports a FEVAR case guided by IVUS. Case Presentation: A 75-year-old male with multiple comorbidities presented with an enlarging AAAc extending to the renal artery ostia, lacking an adequate neck. Anatomical variants included a left renal artery with a caudal origin (pelvic left kidney), a left renal polar artery originating from the right common iliac artery, and a patent inferior mesenteric artery (<3 mm). Following multidisciplinary evaluation, the patient successfully underwent simultaneous FEVAR and coronary angiography. Guided by IVUS, the fenestrated endograft was deployed with preserved visceral patency. The patient recovered uneventfully and was discharged on postoperative day two. A 30-day CT angiogram detected a stable inferior mesenteric artery endoleak, managed conservatively through a 6-month follow-up. Conclusions: IVUS-guided FEVAR may offer a promising alternative to traditional angiography, reducing radiation and contrast exposure. Further large-scale studies are needed to confirm these findings and establish clinical and economic benefits.
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BibTeX
@article{nardi2026intravascular,
title = {{Intravascular Ultrasound (IVUS)-Assisted Fenestrated Endovascular Aortic Repair (FEVAR) for Iuxtarenal Aortic Aneurysm with Pelvic Ectopic Left Kidney and Aberrant Left Renal Arteries: A Case Report.}},
author = {Priscilla Nardi and Giulia Guadalupi and Valerio Rinaldi and Edoardo De Meis and Valeria Iacoucci and Greta D'Onofrio and Eleonora Zedda and Rocco Pasqua and Fabio Miraldi and Gaetano Tanzilli and Nicola Viceconte and Francesco Pelliccia and Giampaolo Prezioso and Vito D'Andrea and Giulio Illuminati},
journal = {Reports (MDPI)},
year = {2026},
month = sep,
doi = {10.3390/reports9040326},
url = {https://europepmc.org/article/MED/42924778},
note = {CC BY},
}
RIS
TY - JOUR
TI - Intravascular Ultrasound (IVUS)-Assisted Fenestrated Endovascular Aortic Repair (FEVAR) for Iuxtarenal Aortic Aneurysm with Pelvic Ectopic Left Kidney and Aberrant Left Renal Arteries: A Case Report.
AU - Priscilla Nardi
AU - Giulia Guadalupi
AU - Valerio Rinaldi
AU - Edoardo De Meis
AU - Valeria Iacoucci
AU - Greta D'Onofrio
AU - Eleonora Zedda
AU - Rocco Pasqua
AU - Fabio Miraldi
AU - Gaetano Tanzilli
AU - Nicola Viceconte
AU - Francesco Pelliccia
AU - Giampaolo Prezioso
AU - Vito D'Andrea
AU - Giulio Illuminati
PY - 2026
DA - 2026/09/27
JO - Reports (MDPI)
DO - 10.3390/reports9040326
UR - https://europepmc.org/article/MED/42924778
AB - Background and Clinical Significance: Complex abdominal aortic aneurysms (AAAc) involving visceral and renal vessels can be treated via open surgery or less invasive fenestrated endovascular aneurysm repair (FEVAR). Intravascular ultrasound (IVUS) minimizes contrast and radiation while improving placement accuracy, though its specific role in FEVAR remains understudied. This CARE-compliant article reports a FEVAR case guided by IVUS. Case Presentation: A 75-year-old male with multiple comorbidities presented with an enlarging AAAc extending to the renal artery ostia, lacking an adequate neck. Anatomical variants included a left renal artery with a caudal origin (pelvic left kidney), a left renal polar artery originating from the right common iliac artery, and a patent inferior mesenteric artery (<3 mm). Following multidisciplinary evaluation, the patient successfully underwent simultaneous FEVAR and coronary angiography. Guided by IVUS, the fenestrated endograft was deployed with preserved visceral patency. The patient recovered uneventfully and was discharged on postoperative day two. A 30-day CT angiogram detected a stable inferior mesenteric artery endoleak, managed conservatively through a 6-month follow-up. Conclusions: IVUS-guided FEVAR may offer a promising alternative to traditional angiography, reducing radiation and contrast exposure. Further large-scale studies are needed to confirm these findings and establish clinical and economic benefits.
SN - 2571-841X
ER -