Surgical repair of a complex renal artery aneurysm through bench surgery and autotransplantation

A 58-year-old woman with underlying medically controlled hypertension presented after an episode of sudden-onset chest pain. Chest computed tomography imaging revealed a left renal artery aneurysm (RAA) measuring 1.6 cm in diameter with mural thrombi in the distal left renal artery at bifurcation level. An interval enlargement of approximately 0.4 cm in diameter was noted within a 6-month period; however, endovascular intervention was not feasible because of the complex RAA pattern. She was hospitalized and received a hand-assisted laparoscopic nephrectomy, ex vivo repair of the RAA, and autotransplantation into the left iliac fossa. The procedure was successful, and the postoperative course went smoothly. The kidney graft was evaluated using a magnetic resonance angiography 1-year postoperatively, which showed no signs of surgical complications or RAA recurrence.