Experience in surgical management of posttraumatic arteriovenous aneurysms of the aortorenal zone

Karpenko A.A., Starodubtsev V.В., Edemskii A.G. Chernyavskii A.M.
Centre for Surgery of the Aorta, Coronary and Peripheral Arteries,
Federal State Facility «Novosibirsk Scientific Research Institute for Circulatory Pathology named after Academician E. N. Meshalkin» under the Federal Agency for High-Technological Medical Care,
Novosibirsk, Russia

Presented herein are two clinical case reports concerning surgical management of posttraumatic arteriovenous aneurysms of the juxtarenal portion of the aorta and left renal vein, demonstrating the informative value of multispiral computed angiography in diagnosis of the pathology involved. Two patients presenting with a stab-and-lacerated wound of the abdominal cavity and subjected to comprehensive examination were found to have an arteriovenous anastomosis between the aorta and left renal vein with the formation of an up to 35-mm aneurysm in one case, and an arteriovenous anastomosis between the left renal artery and left renal vein with the formation of a pseudoaneurysm sized up to 30 mm in the other. Both patients had a clinical picture of cardiopulmonary insufficiency induced by overloading of the right portions of the heart. Both pathologies were treated surgically in the scope of removing the arteriovenous anastomosis and aneurysm of the juxtarenal portion of the abdominal aorta and left renal artery. The postoperative period showed nothing to report and turned out uneventful, with the patients being discharged from the clinic in a satisfactory condition with good laboratory and haemodynamic parameters.

KEY WORDS: arteriovenous fistula, arteriovenous aneurysm, multispiral computed angiography.

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