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Fenestrated endovascular abdominal aortic aneurysm repair with concomitant horseshoe kidney
  1. Sylvie Bowden1 and
  2. Graham Roche-Nagle2
  1. 1Department of Medicine, University of Toronto, Toronto, Ontario, Canada
  2. 2Department of Vascular Surgery, Toronto General Hospital, Toronto, Ontario, Canada
  1. Correspondence to Dr Graham Roche-Nagle; graham.roche-nagle{at}


Horseshoe kidney, representing abnormal fusion of the inferior renal poles, is a rare anatomic anomaly posing challenges in the setting of surgical abdominal aortic aneurysm repair. Historically, open repair has been the favoured surgical approach. However, due to the location of the renal isthmus and wide-ranging variation in anomalous renal vasculature, endovascular aneurysm repair (EVAR) has emerged as a popular, less invasive alternative. We describe one of the first published cases of two-fenestration EVAR in a patient with concomitant horseshoe kidney, followed by a discussion of current trends in surgical management. With the increasing availability to customise fenestrated grafts to patients’ unique anatomy, this advanced EVAR technique may emerge as the preferred approach in certain cases.

  • radiology
  • interventional radiology
  • renal medicine
  • surgery
  • vascular surgery

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  • Contributors SB: Literature review and manuscript preparation. GRN: Guidance and revision.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Obtained.

  • Provenance and peer review Not commissioned; externally peer-reviewed.