JACC Case Rep. 2026 Jul 3:108962. doi: 10.1016/j.jaccas.2026.108962. Online ahead of print.
ABSTRACT
BACKGROUND: Endovascular aortic repair (EVAR) is the gold standard for abdominal aortic aneurysm, but complex anatomy may require individualized strategies.
CASE SUMMARY: We report a 72-year-old multimorbid man with a left ventricular assist device and stage 3 chronic kidney disease, presenting with abdominal aortic aneurysm (up to 7.7 cm), residual type B dissection with unfavorable remodeling, and the left renal artery originating from the false lumen. An interdisciplinary approach consisted of a laparoscopic nephrectomy with ex vivo preservation, followed by EVAR and renal autotransplantation into the right iliac fossa. Postoperative recovery was uneventful, with stable renal function and satisfactory imaging showing exclusion of the entry tear.
DISCUSSION: Standard EVAR would have compromised perfusion of the left kidney. More complex endovascular strategies, including branched or fenestrated repair, were technically prohibitive.
TAKE-HOME MESSAGE: Renal autotransplantation may serve as a viable bailout strategy enabling EVAR in highly selected patients requiring organ preservation.
PMID:42397338 | DOI:10.1016/j.jaccas.2026.108962