Endovascular treatment of a false aneurysm in the site of nephrectomy of a transplanted kidney

Isolated aneurysms of the iliac district are a rare pathology, with a frequency of less than 0.05%. Following aortoiliac surgery, false aneurysms have an incidence ranging between 6.3 to 12.3%. The authors report the case of a 49-year-old woman with chronic renal insufficiency in hemodialysis, who underwent a kidney transplant at the age of 31 on the left external iliac artery and at 34 years the removal of the transplanted kidney owing to chronic rejection. Fifteen years after the kidney explant, a false aneurysm was diagnosed with a diameter of 10 cm, involving the left external iliac artery, the site of the previous explant. This aneurysm was treated using endovascular procedures by positioning a covered stent; 48 h after the insertion of the endoprosthesis, the excluded aneurysmatic effusion was drained using a percutaneous device, under ultrasonographic control. Colour Doppler sonographic controls performed during the follow-up confirmed the correct position of the endoprosthesis and an almost complete resolution of the excluded aneurysmatic effusion. The authors discuss the indications and methods of treatment, also in relation to other experiences reported in the literature.