Complex aortic and bilateral renal artery aneurysm repair in a young patient with multiple arterial aneurysm syndrome Carlos A. Hinojosa, MD, MSc, Javier.

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Complex aortic and bilateral renal artery aneurysm repair in a young patient with multiple arterial aneurysm syndrome Carlos A. Hinojosa, MD, MSc, Javier E. Anaya-Ayala, MD, Hugo Laparra-Escareno, MD, Adriana Torres-Machorro, MD, Rene Lizola, MD Journal of Vascular Surgery Cases and Innovative Techniques Volume 2, Issue 3, Pages 84-87 (September 2016) DOI: 10.1016/j.jvscit.2016.04.001 Copyright © 2016 The Author(s) Terms and Conditions

Fig 1 A and B, Abdominal computed tomography angiography revealed a 26-mm infrarenal aortic aneurysm and bilateral renal artery aneurysms (right, 67 × 46 mm; left, 43 × 17 mm) with a right perinephric hematoma. C and D, Selective catheterization identified extravasation and ruptured right renal artery aneurysm, immediately treated with coil embolization. From Hinojosa CA, Anaya-Ayala JE, Laparra-Escareno H, Torres-Machorro A, Lizola R. Multiple arterial aneurysms in a young Mexican female with possible Loeys-Dietz syndrome. J Vasc Surg 2016;63:295-6. Reprinted with permission from Elsevier. Journal of Vascular Surgery Cases and Innovative Techniques 2016 2, 84-87DOI: (10.1016/j.jvscit.2016.04.001) Copyright © 2016 The Author(s) Terms and Conditions

Fig 2 A, Two years later, computed tomography angiography demonstrated expansion of the aortic aneurysm sac (52 mm) and aneurysmal degeneration in the right renal artery. B, She underwent aortic open repair with a Dacron graft and reconstruction and reimplantation of the right renal artery with a 6-mm expanded polytetrafluoroethylene (ePTFE) graft. From Hinojosa CA, Anaya-Ayala JE, Laparra-Escareno H, Torres-Machorro A, Lizola R. Multiple arterial aneurysms in a young Mexican female with possible Loeys-Dietz syndrome. J Vasc Surg 2016;63:295-6. Reprinted with permission from Elsevier. Journal of Vascular Surgery Cases and Innovative Techniques 2016 2, 84-87DOI: (10.1016/j.jvscit.2016.04.001) Copyright © 2016 The Author(s) Terms and Conditions

Fig 3 A, Thoracic and abdominal computed tomography angiography coronal view at 12 months demonstrated the aortic reconstruction. B, The posterior view with three-dimensional reconstruction demonstrated patent grafts and well-perfused kidneys. Journal of Vascular Surgery Cases and Innovative Techniques 2016 2, 84-87DOI: (10.1016/j.jvscit.2016.04.001) Copyright © 2016 The Author(s) Terms and Conditions