Pancreas graft salvage after successful endovascular treatment of Y graft pseudoaneurysm

Pancreas transplantation is the most successful treatment option for patients with autoimmune type 1 diabetes. However, the surgical procedure is associated with high morbidity rates. The present case report describes a patient receiving simultaneous pancreas/kidney transplantation. After initial success, he develops a pseudoaneurysm of the iliac Y graft reconstruction, necessitating elective transplantectomy to avoid rupture. While on the waiting list for this operation, the patient is admitted to another hospital with acute bleeding from the pseudoaneurysm. An endovascular stent is successfully placed into the Y graft, stopping the bleeding with preserved pancreas function. Close follow-up using CT angiography shows successful treatment of the aneurysm. Pancreas graft function remains excellent. Although most experts until now have advised transplantectomy in the case of Y graft aneurysms, this case report advocates stent placement and close monitoring to preserve the pancreatic graft.