Acta Med. 2021, 64: 232-234

Emergency Ilio-femoral Bypass during Kidney Transplantation due to External Iliac Artery Dissection: Case Report

Ivica Mokosa, Luka PenezićaID, Josip Figla, Bojan Čikića, Marjan Marića, Nikolina Bašić Jukićb, Željko Kaštelana

aDepartment of Urology, University Hospital Center Zagreb, Zagreb, Croatia
bDepartment of Nephrology, Arterial Hypertension and Dialysis, University hospital center Zagreb, Zagreb, Croatia

Received March 9, 2021
Accepted November 16, 2021

Intraoperative iliac artery dissection during kidney transplantation is a rare but serious complication that requires prompt intervention. We present a case of right external iliac artery dissection during deceased donor kidney transplantation. A 57-year-old male patient underwent standard pretransplant evaluation and had no signs of either significant aortoiliac occlusive disease or peripheral arterial occlusive disease. Diabetic nephropathy, arterial hypertension and smoking were the underlying causes of the patient’s end-stage renal disease. Transplantation was performed in the standard fashion. The kidney was positioned in the right iliac fossa and the venous end to-side anastomosis was performed first. A significant dissection of the right external iliac artery was found on arteriotomy. Immediate ilio-femoral bypass with a vascular prosthesis was performed. During two years of follow-up the kidney function is stable and there are no signs of lower limb vascular insufficiency.


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