Purpose
Aneurysms and pseudo-aneurysms of the renal arteries are a rare condition.
The incidence of the aneurysms is 0,1-1% in the general population increasing to 2,5% in the hypertensive population.
Clinically they are usually asymptomatic and are found incidentally in diagnostic imaging studies for other reasons.
The most common symptoms are abdominal or back pain,
hematuria and poorly controlled hypertension.
Aneurysmal rupture is considered a life threatening condition,
and treatment is accepted in the following circumstances:
Asymptomatic renal aneurysm: if the diameter exceeds 15 mm or...
Methods and Materials
From May 2009 to November 2012 we performed seven consecutive endovascular therapeutic procedures,
in six patients affected by aneurysms (n:4) or pseudo-aneurysms (n:2) of the renal arteries.
Treatments were made to achieve the embolization of the lesions in patients with a high risk of rupture of the aneurysms and pseudo-aneurysms,
and to avoid a life threatening bleedingand/or nephrectomy.
One patient was asymptomatic and the lesion was detected on a CT scan performed by other circumstances without relation with renal pathology.
In three cases the lesions...
Results
Five patients were male; ages ranged between 35 and 65 years.
The lesions had saccular morphology and 15mm in diameter or larger,
only one demonstrated intra-renal location.
The procedures were performed in an average of 53 (range 19-92) minutes.
Patient 1 suffered the spontaneous rupture of a previously asymptomatic aneurysm.
The aneurysm was located in a bifurcation of the main anterior branch,
and we decided to perform the embolization of the lesion and the segmental branch arising from it.
In this case was necessary to...
Conclusion
In our patients,
all lesions were successfully treated,
and nephrectomy and other risks from open surgery were avoided too.From a conservative point of view,
the proper election and the suitable combination of the different techniques and devices,
were the key to obtain a successful treatment.
On the other hand,
successive CT scans allowed the detection of complications such as reperfusion of the lesions,
and also allowed the planning of new conservative treatments.
For these reasons,
we consider the endovascular embolization as the elective approachfor treatment...
References
Elaassar O,
Auriol J,
Marquez R et al (2011) Endovascular techniques for treatment of renal artery aneurysms.
Cardiovasc Intervent Radiol34:926-935.
Vignali C,
Lonzi S,
Bargellini I et al (2004) Vascular injuries after percutaneous renal procedures: treatment by transcatheter embolization.
Eur Radiol 14:723-729.
Mulderije ED,
Breden JHM,
Buskens FGM et al (1985).Brit J Radiol 693:896-899.
Personal Information
José Javier Echevarria-UragaMD,
PhD.
Vascular and Interventional Radiology.
Hospital de Galdakao-Usánsolo.
Basque Country.
Spain.
email:
[email protected]