{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T21:56:41Z","timestamp":1781647001076,"version":"3.54.5"},"reference-count":6,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,4,2]],"date-time":"2026-04-02T00:00:00Z","timestamp":1775088000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,5,13]],"date-time":"2026-05-13T00:00:00Z","timestamp":1778630400000},"content-version":"vor","delay-in-days":41,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Gen Thorac Cardiovasc Surg Cases"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Renal artery aneurysm (RAA) is a rare but potentially life-threatening vascular pathology. Surgical management depends on the aneurysm\u2019s location and morphology. In cases with extensive aortic calcification or anatomical complexity, standard clamping techniques may be infeasible, requiring alternative hemostatic strategies. We present a unique case of RAA in a patient with Takayasu\u2019s arteritis and diffuse aortic calcification, in whom intra-aortic balloon occlusion and patch aortoplasty were used as a salvage technique during surgical repair.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Case Presentation<\/jats:title>\n                    <jats:p>An 80-year-old woman with a history of Takayasu\u2019s arteritis was referred for surgical treatment of an enlarging right RAA (55\u2009\u00d7\u200974\u00a0mm), incidentally detected on imaging during hospitalization for pneumonia. Preoperative computed tomography (CT) demonstrated diffuse calcification of the entire aorta and an aneurysm located at the origin of the right renal artery. The distal segment of the right renal artery was occluded, and the right kidney could not be identified. Due to anticipated bleeding risk and poor clamping accessibility, cardiopulmonary bypass was established via the right femoral vessels. Multiple intra-aortic balloon occlusion catheters were inserted, though several ruptured intraoperatively. Hemostasis was ultimately achieved by inflating a balloon inserted directly through the operative field and performing a patch closure of the dilated right renal artery ostium. The patient required massive transfusion and temporary renal replacement therapy postoperatively. She was discharged to rehabilitation on postoperative day 49. Postoperative CT confirmed patch integrity, but a localized aortic dissection at the balloon site was observed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This case illustrated the technical challenges of surgical approaches for RAA in patients with severe aortic calcification due to Takayasu\u2019s arteritis. Intra-aortic balloon occlusion is a useful alternative to conventional clamping but carries a risk of rupture, particularly in calcified aorta. Patch aortoplasty may be considered for elderly patients where graft replacement is not feasible. Preoperative imaging is essential to plan individualized strategies for bleeding control and vascular access in high-risk patients.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s44215-026-00255-4","type":"journal-article","created":{"date-parts":[[2026,4,2]],"date-time":"2026-04-02T10:59:25Z","timestamp":1775127565000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Resection and patch aortoplasty for right renal artery aneurysm through a midline laparotomy"],"prefix":"10.1186","volume":"5","author":[{"given":"Ryo","family":"Nakanishi","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiroaki","family":"Osada","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takehiko","family":"Matsuo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7828-9762","authenticated-orcid":false,"given":"Kenji","family":"Minatoya","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,4,2]]},"reference":[{"key":"255_CR1","doi-asserted-by":"publisher","first-page":"454","DOI":"10.1097\/00000658-200110000-00005","volume":"234","author":"PK Henke","year":"2001","unstructured":"Henke PK, Cardneau JD, Welling TH 3rd, Upchurch GR Jr, Wakefield TW, Jacobs LA, et al. Renal artery aneurysms: a 35-year clinical experience with 252 aneurysms in 168 patients. Ann Surg. 2001;234:454\u201362. discussion 462\u20133.","journal-title":"Ann Surg"},{"key":"255_CR2","first-page":"277","volume":"1","author":"JR Frederick","year":"2012","unstructured":"Frederick JR, Woo YJ. Thoracoabdominal aortic aneurysm. Ann Cardiothorac Surg. 2012;1:277\u201385.","journal-title":"Ann Cardiothorac Surg"},{"issue":"5","key":"255_CR3","doi-asserted-by":"publisher","first-page":"1914","DOI":"10.1016\/j.athoracsur.2011.05.039","volume":"92","author":"F Hokenek","year":"2011","unstructured":"Hokenek F, Gursoy M, Ozgol I, Gulcan F, K\u0131noglu B. A new proximal anastomosis technique in two patients with severely calcified aorta. Ann Thorac Surg. 2011;92(5):1914\u20136.","journal-title":"Ann Thorac Surg"},{"issue":"1","key":"255_CR4","doi-asserted-by":"publisher","first-page":"24","DOI":"10.5090\/kjtcs.2012.45.1.24","volume":"45","author":"S Chung","year":"2012","unstructured":"Chung S, Park PW, Choi MS, Cho SH, Sung KI, Lee YT, et al. Surgical experience of ascending aorta and aortic valve replacement in patient with calcified aorta. Korean J Thorac Cardiovasc Surg. 2012;45(1):24\u20139.","journal-title":"Korean J Thorac Cardiovasc Surg"},{"issue":"10","key":"255_CR5","first-page":"S29","volume":"35","author":"A Cartier","year":"2019","unstructured":"Cartier A, Dagenais F, Perron J. Long-term outcome of patients treated with patch aortoplasty for aortic coarctation. Can J Cardiol. 2019;35(10):S29\u201330.","journal-title":"Can J Cardiol"},{"issue":"2","key":"255_CR6","doi-asserted-by":"publisher","first-page":"296","DOI":"10.1007\/s00246-012-0442-1","volume":"34","author":"JW Cramer","year":"2013","unstructured":"Cramer JW, Ginde S, Bartz PJ, Tweddell JS, Litwin SB, Earing MG. Aortic aneurysms remain a significant source of morbidity and mortality after use of Dacron(\u00ae) patch aortoplasty to repair coarctation of the aorta: results from a single center. Pediatr Cardiol. 2013;34(2):296\u2013301.","journal-title":"Pediatr Cardiol"}],"container-title":["General Thoracic and Cardiovascular Surgery Cases"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s44215-026-00255-4","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s44215-026-00255-4.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s44215-026-00255-4.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T21:24:20Z","timestamp":1781645060000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1186\/s44215-026-00255-4"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,4,2]]},"references-count":6,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,12]]}},"alternative-id":["255"],"URL":"https:\/\/doi.org\/10.1186\/s44215-026-00255-4","relation":{},"ISSN":["2731-6203"],"issn-type":[{"value":"2731-6203","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,4,2]]},"assertion":[{"value":"24 August 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"18 March 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"2 April 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Our institution does not require ethical approval to report individual cases or case series.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Written informed consent was obtained from the patient and his family.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors have no relevant competing interests to disclose regarding this article.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"20"}}