Abstract
A 48-year-old man was admitted to our hospital with the chief complaint of left epigastralgia. Computed tomography (CT) images revealed a renal artery aneurysm (diameter, 2.8 cm) at the bifurcation of the left renal artery. Open repair was performed using median laparotomy by renal mobilization as far as possible to the center of the operative field. Both topical cooling by ice slush and cold perfusion were performed for renal protection. After clamping the renal artery and vein, the cold perfusate was irrigated with effluent from the orifice of the renal vein venotomy every 30 min. Two anterior branches and a posterior branch that were approximately 2 mm in diameter were reconstructed using 2 separate saphenous vein grafts. The renal ischemic time was 230 min because the reconstruction was complicated. His postoperative renal function decreased slightly but improved 6 months later. The renal protection method was effective. Detailed preoperative planning for reconstruction is essential in such a complex renal artery aneurysm.
