Catheter occlusion of a mycotic renal artery aneurysm with cure of associated renovascular hypertension

Nosher, John L.; Needell, Gary S.; Bialy, Grace B.; Zatina, Michael A.

doi:10.1007/bf02575427

Cited by 15 publications

(14 citation statements)

References 14 publications

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“…Other causes include inflammation or infection (29). Traumatic pedicular aneurysms can be due to a direct wound or to dissection of the media due to deceleration in a car accident.…”

Section: Indicationsmentioning

confidence: 99%

Transcatheter Arterial Embolization in Patients with Kidney Diseases: an Overview of the Technical Aspects and Clinical Indications

et al. 2010

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Therapeutic embolization is defined as the voluntary occlusion of one or several vessels, and this is achieved by inserting material into the lumen to obtain transient or permanent thrombosis in the downstream vascular bed. There are a number of indications for this approach in urological practice, in particular for the patients with parenchymatous or vascular kidney disease. In this review, we present the different embolization techniques and the principally employed occluding agents, and then we present the principal clinical indications and we discuss other pathologies that may benefit from this non-invasive therapy. The complications, side effects and main precautions associated with this approach are also described.

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“…Other causes include inflammation or infection (29). Traumatic pedicular aneurysms can be due to a direct wound or to dissection of the media due to deceleration in a car accident.…”

Section: Indicationsmentioning

confidence: 99%

Transcatheter Arterial Embolization in Patients with Kidney Diseases: an Overview of the Technical Aspects and Clinical Indications

et al. 2010

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“…Although the benefit of treating an aneurysm associated the aneurysmal sac. The use of NDCs to treat true aneurysms may have with hypertension is controversial, several authors have described significant improvements in hypertension after some disadvantages and risks, including uncontrolled delivery of the coils, misembolization or coil migration treating the aneurysm, either surgically or by endovascular treatment [13,16,17,20]. We believe that hypertenin normal renal artery branches and resulting renal infarcts.…”

Section: Resultsmentioning

confidence: 99%

“…balloons, steel coils and particulate agents has been used in both extra-and intrarenal aneurysms [13,20,22,24]. In three patients with recurrent infarctions, the signs and symptoms of renal embolism disappeared immediHowever, most of these studies have shown that the embolization resulted in occlusion of a renal artery ately after embolotherapy and two patients with haematuria improved immediately after embolotherapy.…”

Section: Resultsmentioning

confidence: 99%

Endovascular treatment of renal artery aneurysms with conventional non‐detachable microcoils and Guglielmi detachable coils

Klein¹,

Szolar²,

Breinl³

et al. 1997

British Journal of Urology

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Objective To evaluate the efficacy and safety of endovascular occlusion of true renal artery aneurysms (RAAs) with conventional non‐detachable microcoils (NDCs) and Guglielmi detachable coils (GDCs). Patients and methods Over a 5‐year period, 12 RAAs were treated by endovascular selective embolization. Four RAAs were occluded using NDCs and eight were treated with GDCs. All coils were delivered through a microcatheter. Eight RAAs were located in the bifurcation of the main renal artery, two in the main renal artery and two were intrarenal. Before treatment, four patients presented with hypertension, one associated with renal infarction and a second had flank pain due to microembolization. Two other patients had renal infarction, associated with haematuria in one; one other patient also had haematuria and five patients were asymptomatic. All patients were followed using clinical and angiographic examinations after 6 months, 1 and 2 years. Results All RAAs were occluded successfully. In two patients treated with NDCs there were minor complications, i.e. one subsegmental peripheral infarction and one misembolization, both without clinical symptoms. In the group treated with GDCs there were no complications. Five of seven patients were clinically improved, while two patients remained clinically unchanged. Conclusion Superselective endovascular treatment of RAAs with microcoils is a safe, efficient, and less invasive alternative to surgical treatment. The high flexibility and softness of the GDC and the controlled detachment enables a safer and more complete occlusion of RAA than current alternatives.

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“…Some advocate elective repair of large aneurysms, aneurysms in pregnancy [22,23] and aneurysms complicated by arterio-venous fistula formation [30]. Aneurysmectomy is the standard treatment; however, newer treatment options include coil embolization and covered stent grafts [31][32][33][34][35].…”

Section: Discussionmentioning

confidence: 99%

Renal artery aneurysms: diagnosis and surveillance with 3D contrast-enhanced magnetic resonance angiography

et al. 2004

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The use of contrast-enhanced magnetic resonance angiography (CE-MRA) in screening for suspected renovascular disease may result in increased detection of renal artery aneurysms. We report the CE-MRA findings at diagnosis and follow-up in nine hypertensive patients with unsuspected renal artery aneurysms. A search of renal CE-MRAs of suspected renal artery stenosis at two tertiary referral institutions over 5 1/2 years was performed. All patients underwent CE-MRA using a fast spoiled gradient echo technique (TR/TE/flip 5.1-6 ms/1.6 ms/40 degrees), scan matrix 512 x 196-224, 1 excitation, FOV 400-450 mm x 266-360 mm, 32-50 mm x 1.5-2 mm interpolated slices. Gadolinium-enhanced 3D images were obtained during breath holding. Images were evaluated and post-processed on a workstation by a single operator. Nine patients with renal artery aneurysms out of a total of 912 cases were found, all involving the main artery or divisions proximal to the renal hilum. Renal arteries distal to the hilum were not consistently visualized. The aneurysm was bilobed in one patient, multilocular in another and unilocular in all others. Severe stenosis of the renal artery proximal to the aneurysm was present in two. Four patients underwent follow-up showing no change in aneurysm size. CE-MRA reliably identifies aneurysms involving the main renal arteries and proximal branches. Once diagnosed, CE-MRA offers a safe, non-invasive modality for surveillance of aneurysm if active intervention is not planned.

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Catheter occlusion of a mycotic renal artery aneurysm with cure of associated renovascular hypertension

Abstract: We describe successful transcatheter occlusion of a mycotic renal artery aneurysm. The patient's hypertension resolved following occlusion of the aneurysm and infarction of the renal parenchyma in the distribution of the aneurysmal vessel.

Cited by 15 publications

References 14 publications

Transcatheter Arterial Embolization in Patients with Kidney Diseases: an Overview of the Technical Aspects and Clinical Indications

Transcatheter Arterial Embolization in Patients with Kidney Diseases: an Overview of the Technical Aspects and Clinical Indications

Endovascular treatment of renal artery aneurysms with conventional non‐detachable microcoils and Guglielmi detachable coils

Renal artery aneurysms: diagnosis and surveillance with 3D contrast-enhanced magnetic resonance angiography

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