A Novel Hybrid Approach to Manage Mycotic Pseudoaneurysm Post-Renal Transplantation: Successful Graft Preservation

<i>Background and Objectives</i>: Post-transplant anastomotic pseudoaneurysms are a rare but serious complication of renal transplantation, typically requiring graft sacrifice. This case report demonstrates a novel hybrid approach for managing a mycotic pseudoaneurysm while preserving graft function. <i>Case report:</i> A 56-year-old male developed a pseudoaneurysm at the anastomotic site after cadaveric kidney transplantation, presenting with recurrent infections and declining renal function. Imaging confirmed the pseudoaneurysm. A hybrid strategy combining femoral-femoral bypass with a polytetrafluoroethylene graft, percutaneous transluminal angioplasty with stenting, and coil embolization was performed. <i>Results</i>: The intervention successfully isolated the pseudoaneurysm and preserved graft function. Post-procedure, serum creatinine levels improved, stabilizing at 2.3 mg/dL during follow-up. Imaging confirmed no residual flow in the aneurysm, and vascular complications were absent. <i>Conclusions</i>: This report highlights a successful combined surgical and endovascular approach for treating mycotic pseudoaneurysms, preserving graft function and restoring limb blood flow. This strategy offers a promising alternative for managing complex post-transplant complications, though long-term outcomes require further evaluation.