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CASE REPORT
Year : 2014  |  Volume : 8  |  Issue : 2  |  Page : 51-53

External iliac artery dissection after renal transplant


1 Professor & Chief, Department of Urology & Renal Transplantation, Nizam's Institute of Medical Sciences, Hyderabad, Andhra Pradesh 500082, India
2 Additional Professor, Department of Urology, Nizam's Institute of Medical Sciences, Hyderabad, Andhra Pradesh 500082, India
3 Professor, Department of Vascular Surgery, Nizam's Institute of Medical Sciences, Hyderabad, Andhra Pradesh 500082, India
4 Professor, Department of Cardio-Thoracic Surgery, Nizam's Institute of Medical Sciences, Hyderabad, Andhra Pradesh 500082, India

Correspondence Address:
V.L.N Murthy Pisapati
Professor & Chief, Department of Urology & Renal Transplantation, Nizam's Institute of Medical Sciences, Hyderabad, Andhra Pradesh 500082
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.1016/j.ijt.2014.04.001

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Dissection of the external iliac artery is rare but a serious complication after renal allograft transplantation endangering the graft and the lower limb as well. We report a case of right external iliac artery dissection in a diabetic and hypertensive patient immediately after transplant resulting in cessation of blood supply to the graft and lower limb. The dissected segment was resected and replaced by a synthetic graft there by restoring the blood supply to the lower limb. The renal graft was removed, re-perfused with cold saline and anastomosed to the internal iliac artery and the arterial blood flow was immediately restored. The postoperative course was uneventful and soon after transplantation the graft functioned well. The patient completed 6-month follow-up with a serum creatinine of 1.0 mg%. We suspect that the vascular clamps might have injured the intima of the external iliac artery, so one should be careful while applying clamps in diseased arteries, which may look apparently normal on Doppler. Occlusion of these diseased arteries by a snare technique during anastomosis is safer in such situations.


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