Rescue Transplant Renal Artery Stenting With Off Label Advanta V12 Covered Stent for Extrarenal Pseudoaneurysm: A Case of Renal Graft Dysfunction Due to Pseudomonas Septicemia

Abstract

Among the vascular complications in post-renal transplant recipients, extrarenal pseudoaneurysms are extremely rare < 1%, but can cause allograft loss and mortality. The most common cause of mycotic pseudoaneurysm is fungal followed by bacterial. Among the bacteria, pseudomonas aeruginosa is the most com`mon organism. The treatment of extrarenal pseudoaneurysms are individualized and transplant nephrectomy is the gold standard for definitive treatment but with the expense of allograft loss. In hemodynamic instability, endovascular prosthesis has become the first choice for salvaging the renal allograft. We present a case of transplant renal artery (TRA) mycotic pseudoaneurysm in the setting of pseudomonas septicemia presented with allograft dysfunction 42 days post-renal transplant, successfully salvaged with endovascular technique using the Advanta V12 covered stent.