Thoracoabdominal aortic aneurysm open repair with bilateral multiple renal arteries

Multiple renal arteries are a common renal vascular variant. A study with 800 kidneys from cadaver donors demonstrated 1% prevalence of quadruple renal arteries. During thoracoabdominal aortic aneurysm (TAAA) repair, this anomaly implies longer time of renal ischemia and well-defined reperfusion strategy.2 Acute kidney injury during TAAA repair is a common complication with 6% to 7% incidence. It can be prevented by histidine-tryptophan-ketoglutarate solution (Custodiol; Dr Franz-Köhler Chemie GmbH, Bensheim, Germany) renal perfusion. We report successful organ preservation during TAAA open repair in a 61-year-old man with multiple renal arteries.