Endovascular treatment of patients with aortic and iliac aneurysms and congenital pelvic kidney: a systematic review.

Introduction: Congenital pelvic kidney is a rare condition that complicates the treatment of abdominal aortic aneurysms due to its variable arterial anatomy. Traditionally, most patients were treated with open or hybrid surgery. However, recent advancements in endovascular devices have allowed to manage complex aortic anatomies. Given the limited data, we conducted a systematic review of cases involving congenital pelvic kidneys with non-ruptured aortic and iliac aneurysms treated using endovascular techniques.

Evidence acquisition: We performed a literature search in PubMed and Google Scholar using terms such as "aortic aneurysm," "congenital pelvic kidney," "ectopic," "variation," "anomaly," and "endovascular procedures." Only cases of non-ruptured aortic, thoracoabdominal, or isolated iliac aneurysms associated with congenital pelvic kidney treated exclusively with endovascular methods were included.

Evidence synthesis: Ten patients (mean age 69.7 years) from three observational studies and six case reports were identified. Half had infrarenal aortic aneurysms, while others presented with iliac or thoracoabdominal aneurysms. Renal arteries most commonly originated from the common iliac artery (N.=4). Various endovascular techniques were employed, including infrarenal endovascular aneurysm repair (EVAR), fenestrated/branched EVAR (F/BEVAR), iliac branched devices (IBD), and chimney EVAR (chEVAR), with a technical success rate of 100%. No postoperative renal function impairment was noted.

Conclusions: Endovascular treatment for patients with congenital pelvic kidney and aortic or iliac aneurysms is effective, achieving high technical success and low complication rates. Complex endovascular devices play a crucial role in managing the unique arterial challenges of this condition.