Horseshoe Kidney and Aortic Aneurysm Management

Horseshoe kidney is a congenital anomaly characterised by fusion of the lower renal poles across the midline, often accompanied by multiple accessory arteries and aberrant ureteral courses. When an abdominal aortic aneurysm coexists, surgical and endovascular repair techniques become markedly more complex. Precise preoperative imaging and vascular mapping are essential to identify renal perfusion territories, assess the risk of ischaemia and plan arterial preservation or reconstruction. Conventional open repair allows direct visualisation and reimplantation of anomalous vessels but may entail greater operative morbidity. In contrast, endovascular aortic repair offers a minimally invasive alternative, utilising custom fenestrated or branched stent grafts to maintain renal blood flow through accessory arteries. Recent advances in three-dimensional segmentation and intraprocedural guidance have improved the accuracy of device deployment and reduced perioperative renal impairment. Optimal management requires a multidisciplinary team versed in nephrology, vascular surgery and interventional radiology to tailor interventions that balance aneurysm exclusion with preservation of renal function.

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Horseshoe Kidney and Aortic Aneurysm Management publication trend

The graph below shows the total number of articles in horseshoe kidney and aortic aneurysm management across all publications each year (not limited to Nature Index journals).

Technical terms

Horseshoe kidney: A congenital renal fusion anomaly in which the lower poles of the kidneys are joined, resulting in an isthmus of renal tissue that crosses the midline.

Abdominal aortic aneurysm: A dilation of the abdominal aorta exceeding 50% of normal diameter, which poses a risk of rupture.

Computed tomography angiography (CTA): An imaging modality combining CT scanning with intravenous contrast to visualise vascular anatomy in detail.

Endovascular aortic repair (EVAR): A minimally invasive procedure that excludes an aneurysm by deploying a stent graft within the aortic lumen.

Accessory renal artery: An additional arterial branch supplying renal tissue, common in horseshoe kidney and critical to preservation of kidney function during repair.

References

1. Semiautomatic volume measure of kidney vascular territories on CT angiography to plan aortic aneurysm repair in patients with horseshoe kidney. European Radiology Experimental (2024).
2. Abdominal aortic aneurysm with horseshoe kidney with central renal artery: A vascular dilemma. Journal of Vascular Surgery Cases and Innovative Techniques (2024).
3. Horseshoe kidney: Morphologic features, embryologic and genetic etiologies, and surgical implications. Clinical Anatomy (2023).