Endovascular Aortic Aneurysm Repair for Abdominal Aortic Aneurysm With Type V Horseshoe Kidney

Purpose: Abdominal aortic aneurysm (AAA) with concomitant Horseshoe kidney (HSK) is rare. When open surgery is not feasible, preserving the renal isthmus artery (RIA) during endovascular treatment presents a challenge.Case report: A 70-year-old male presented with a 57.8 mm x 54.3 mm AAA and type V HSK perfused by a 4.4 mm RIA from the inferior mesenteric artery and a 4.6 mm RIA from the aortic bifurcation. This case report describes an endovascular aortic aneurysm repair (EVAR) performed on an AAA coexisting with a type V HSK. One-year follow-up: the AAA had regressed, and the HSK remained perfused without any endoleak or increase in serum creatinine levels.Conclusion: The utilization of EVAR offers a feasible option for AAA combined with type V HSK, particularly in cases of high surgical risk.Clinical Impact In Abdominal aortic aneurysm (AAA) with type V horseshoe kidney (HSK), preserving renal isthmus arteries (RIAs) is critical when they provide a substantial portion of the HSK blood supply.When open surgery is not feasible, preserving the RIA during endovascular treatment presents a challenge.The use of EVAR, incorporating a periscope stent and embolization, provides a viable treatment option for patients with AAA and type V HSK, especially in high surgical risk cases.