Endovascular aneurysm repair in a patient with horeshoe kidney and impaired renal function

We present the case of an 80 year old female with a three week history of lower backache and a pulsatile mass in the epigastrium. CT angiogram confirmed the presence of an infrarenal abdominal aortic aneurysm [AAA] co-existent with a horseshoe kidney [HSK]. Due to associated co-morbidities of hypertension, moderate renal failure, chronic obstructive pulmonary disease [COPD] and morbid obesity, she underwent endovascular repair of the abdominal aortic aneurysm. The presence of the horseshoe kidney poses significant difficulty during open repair of AAA, which can be circumvented in favourable cases by endovascular repair, though the latter procedure is not risk-free