Novel Modified Iliac Artery Stent Graft with Side Branch Extension Facilitating Kidney Transplant in Severe Aortoiliac Occlusive Disease.

Kidney Transplant is the preferred treatment for end-stage renal disease (ESRD) patients. However, a subset of otherwise eligible patients have severe iliac artery calcification that preclude them from receiving a kidney transplant. This report highlights the application of a physician-modified external iliac artery stent graft with a side branch extension (SBE) to facilitate successful kidney transplantation in a 69-year-old African American female who was otherwise ineligible for kidney transplant due to the presence of severe circumferential bilateral iliac artery calcification. Four months later, the patient received a kidney transplant and recovered without complications. Her duplex ultrasound (DUS) revealed patent vasculature to the kidney graft, she produced adequate urine output, and creatinine and glomerular filtration rate (GFR) normalized by discharge. This underscores the potential for stent graft with SBE as an option for patients who were traditionally ineligible for kidney transplantation due to the presence of severe aortoiliac calcification.