PMC5576161_01
Horseshoe kidney classification system based on the vasculature supplying the horseshoe kidney.
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Based on the Eisendrath classification system, it was determined to be a Type V HSK (Fig. 1).
Dyna computed tomography scan demonstrating a large inferior mesenteric artery near the origin of the abdominal aortic aneurysm. The complex renal artery anatomy can be visualized as well.
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Following this imaging, a Dyna CT scan using 75 mL of contrast revealed a large inferior mesenteric artery (IMA) arising approximately 1 cm above the level of the aneurysm with a neck length of 5 mm available below the IMA (Fig. 2).
Completion angiogram after placement of inferior mesenteric artery chimney stent and EVAR. There is no evidence of endoleak and the inferior mesenteric artery stent is widely patent.
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A completion angiogram revealed patent renal arteries, IMA snorkel stent-graft and no evidence of an endoleak (Fig. 3).
Cross-sectional imaging that demonstrates the interaction between the inferior mesenteric artery chimney stent and the proximal EVAR fixation.  : The location of the IMA chimney stent in front of the EVAR graft.
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At 1 month, cross-sectional imaging showed the endograft and the IMA chimney stent relation to each other (Fig. 4).
Computed tomography angiography (CTA) reconstruction demonstrating widely patent inferior mesenteric artery stent on 3-month follow-up CTA.
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CT-angiography at 3 months revealed a widely patent IMA (Fig. 5).
Type II endoleak arising from the right side of the horseshoe kidney. (A-C) The course of this artery leading to the endoleak. The partial nephrectomy resolved this problem.
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Type II endoleak arising from one of the feeding right renal arteries was present (Fig. 6).