Utilizing 3D printing to facilitate surgical in-situ paediatric renal artery aneurysm repair for refractory hypertension

TY - JOUR

T1 - Utilizing 3D printing to facilitate surgical in-situ paediatric renal artery aneurysm repair for refractory hypertension

AU - Chandak, Pankaj

AU - Kessaris, Nicos

AU - Karunanithy, Narayan

AU - Byrne, Nick

AU - Newton, Joanna

AU - Bharadwaj, R.

AU - Assia-Zamora, Sergio

AU - Shenoy, Mohan

AU - Sallam, Morad

AU - Sinha, Manish D.

N1 - Funding Information: Funding/Support: This work was supported by the Guy's and St. Thomas’ Charity, grant code EFT140802. Funding Information: This work was supported by the Guy's and St. Thomas’ Charity, and we thank the family and patient consent was obtained for this study. Publisher Copyright: © 2023 Lippincott Williams and Wilkins. All rights reserved.

PY - 2023/1/1

Y1 - 2023/1/1

N2 - Renal artery aneurysmal (RAA) disease is a rare, but potentially life-threatening cause of renovascular disease presenting with hypertension. Conventional management involves aneurysmal excision followed by renal auto-transplantation. We present the management of a 13-year-old girl with complex multiple saccular aneurysmal disease of the left renal artery with hilar extension and symptomatic hypertension. We used 3D printing to print a patient-specific model that was not implanted in the patient but was used for surgical planning and discussion with the patient and their family. Endovascular options were precluded due to anatomical complexities. Following multi-disciplinary review and patient-specific 3D printing, she underwent successful in-situ RAA repair with intraoperative cooling, without the need for auto-transplantation. 3D printing enabled appreciation of aneurysmal spatial configuration and dimensions that also helped plan the interposition graft length needed following aneurysmal excision. The models provided informed multidisciplinary communications and proved valuable during the consent process with the family for this high-risk procedure. To our knowledge, this is the first reported case utilizing 3D printing to facilitate in-situ complex repair of RAA with intra-hilar extension for paediatric renovascular disease.

AB - Renal artery aneurysmal (RAA) disease is a rare, but potentially life-threatening cause of renovascular disease presenting with hypertension. Conventional management involves aneurysmal excision followed by renal auto-transplantation. We present the management of a 13-year-old girl with complex multiple saccular aneurysmal disease of the left renal artery with hilar extension and symptomatic hypertension. We used 3D printing to print a patient-specific model that was not implanted in the patient but was used for surgical planning and discussion with the patient and their family. Endovascular options were precluded due to anatomical complexities. Following multi-disciplinary review and patient-specific 3D printing, she underwent successful in-situ RAA repair with intraoperative cooling, without the need for auto-transplantation. 3D printing enabled appreciation of aneurysmal spatial configuration and dimensions that also helped plan the interposition graft length needed following aneurysmal excision. The models provided informed multidisciplinary communications and proved valuable during the consent process with the family for this high-risk procedure. To our knowledge, this is the first reported case utilizing 3D printing to facilitate in-situ complex repair of RAA with intra-hilar extension for paediatric renovascular disease.

KW - 3D printing

KW - hypertension

KW - in-situ repair

KW - paediatric

KW - renal artery aneurysm

KW - renovascular

UR - http://www.scopus.com/inward/record.url?scp=85143180905&partnerID=8YFLogxK

U2 - 10.1097/HJH.0000000000003296

DO - 10.1097/HJH.0000000000003296

M3 - Article

C2 - 36129111

AN - SCOPUS:85143180905

SN - 0263-6352

VL - 41

SP - 194

EP - 197

JO - Journal of hypertension

JF - Journal of hypertension

IS - 1

ER -