Tratamento endovascular do aneurisma da aorta abdominal em paciente com insuficiência renal crônica

Non-dialytic chronic renal failure is a contraindication related to the endovascular treatment of abdominal aortic aneurysms. The use of alternative contrast agents, such as gadolinium, provides good-quality images and is associated with nephrotoxicity. We report a case of endovascular treatment of an abdominal aortic aneurysm guided by color-flow Doppler ultrasonography. An 82-year-old male patient, with abdominal aortic aneurysm (55 mm in diameter) and creatinine clearance of 17 ml/min, underwent implantation of modular bifurcated aortic stent-graft, using that imaging method associated with radioscopy. Iodinated contrast was not used. The immediate result and 1- and 6-month controls showed complete aneurysm exclusion. Renal function is still unaltered. We conclude that the stent-graft implantation guided by color-flow Doppler ultrasonography in patients with nonterminal chronic renal failure and with favorable anatomy is a feasible and safe method.