Purpose
Renal artery aneurysms (RAA) are uncommon conditions,
with a reported prevalence of 0.01% and1.0% (01-09).
They correspond to the 22% of visceral aneurysms and most are due to fibromuscolardysplasia and atherosclerosis.
However,
these aneurysms can also arise from congenital disorders(i.e.,
Ehlers- Danlos syndrome and neurofibromatosis),
trauma,
dissection,
infectious sources,
andinflammatory causes,
such as polyarteritis nodosa (02,06-13).
The risk of rupture seems to increaseas the diameter exceeds 1,5 cm,
with a 20-100% rupture-related mortality rate (03,07,10,14,15).Often,
before the rupture,
this pathology is asymptomatic and the diagnosis...
Methods and Materials
We retrospectively analyzed seven consecutive patients with eight renal artery aneurysms whounderwent endovascular treatment from 2004 to 2009 using stent grafts in our institution.
Thesepatients were referred from Nephrology to Diagnostic Imaging Department to be examined due toarterial hypertension (137.9±35.0 mmHg) refractory to pharmacological treatment (Table I).Patients did not have a family history of hypertension,
and they suffered from headache anddizziness (2 patients),
macroscopic hematuria and backache (1 patient),
and abdominal bruits (3patients).
In all patients have been previously examinated the following laboratory indexes:glomerular filtration...
Results
Patients were aged between 63 and 78 years and presented,
as risk factors,
hypertension (n:7,
100%),
smoke habit (n:1,
14%) and dislypidemia (n:1,
14%).
Five of the eight aneurysms were placed
on left renal artery (63%) ,
three on right side (37%) and all lesions presented the followingcharacteristics: diameter of the sac between 29 and 55 mm (mean = 32.5 5 mm ) (Table I)characterized by a saccular shape (100%),
presence of an associated stenosis in two of the eightlesions (25%),
average length of...
Conclusion
At our knowledge,
this is the largest case history in which covered stent deployment on renal arteryaneurysm limited to the main renal artery is considered.
The procedure was shown to be safe forkidney function,
feasible to exclude the aneurismatic sac and to restore vessel patency.
At long-term
follow-up high technical success rate and good clinical outcome are resulted,
even if a widerpatients number and a randomized trial are required in order to demonstrate the feasibility andeffectiveness of the endovascular approach.
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