Ferumoxytol-enhanced magnetic resonance angiography for endovascular aortic repair surveillance in a patient after renal transplant

Endovascular aneurysm repair requires lifelong imaging surveillance, typically with contrast-enhanced computed tomography imaging. This poses risks to patients with end-stage renal disease. Ferumoxytol, a superparamagnetic iron-based nanoparticle with minimal nephrotoxicity, has emerged as an alternative contrast agent for magnetic resonance angiography in patients with renal impairment. We present a case of a patient with a failing renal transplant who underwent ferumoxytol-enhanced magnetic resonance angiography to further characterize an indeterminant etiology of continued aneurysm sac expansion to 10 cm, avoiding iodinated and gadolinium-based contrast while achieving high-quality imaging for endoleak detection.