Conservative management of renal artery pseudoaneurysm following partial nephrectomy

Darbyshire, Daniel; Dukic, I.; Ali, Zara; Shackley, David

doi:10.1308/003588414x13814021678673

Cited by 8 publications

(3 citation statements)

References 6 publications

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“…Darbyshire et al reported a case of renal artery pseudoaneurysm successfully managed conservatively, giving another potential management option in non-torrential hemorrhage. 4 …”

Section: Discussionmentioning

confidence: 99%

Intraparenchymal renal artery pseudoaneurysm following nephrostomy tube insertion in a patient with a solitary kidney: A case report

Medina

Hevia-Palacios

Laso-García

et al. 2021

Urology Case Reports

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Intraparenchymal renal artery aneurysms are uncommon and represent less than 10% of all renal artery aneurysms. They are caused by trauma or iatrogenic injury, and their rupture can lead to life-threatening hemorrhage. We report the case of a 48-year-old male with history of left solitary kidney and orthotopic neobladder, who presented with massive hematuria 7 days after nephrostomy tube placement because of obstructive uropathy and acute renal failure due to ureteroileal stricture. An abdominal CT angiography revealed an intraparenchymal renal artery aneurysm, and it was successfully treated with superselective endovascular embolization, achieving maximal parenchymal preservation.

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“…Darbyshire et al reported a case of renal artery pseudoaneurysm successfully managed conservatively, giving another potential management option in non-torrential hemorrhage. 4 …”

Section: Discussionmentioning

confidence: 99%

Intraparenchymal renal artery pseudoaneurysm following nephrostomy tube insertion in a patient with a solitary kidney: A case report

Medina

Hevia-Palacios

Laso-García

et al. 2021

Urology Case Reports

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show abstract

“…However, it is difficult to not treat RAPs or AVFs if they are apparent. Although in rare cases bleeding due to RAP disappears spontaneously, Hyams et al reported that the rate of resolution with conservative management alone was 11% (Hyams et al 2011 ; Darbyshire et al 2014 ). Further studies are required to investigate what kind of RAPs or AVFs can in the future be managed with conservative treatment.…”

Section: Discussionmentioning

confidence: 99%

Mid-term outcome of transarterial embolization of renal artery pseudoaneurysm and arteriovenous fistula after partial nephrectomy screened by early postoperative contrast-enhanced CT

et al. 2020

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Purpose To retrospectively evaluate the mid-term outcome of transarterial embolization (TAE) of renal artery pseudoaneurysm (RAP) including arteriovenous fistula (AVF) after partial nephrectomy screened by early postoperative contrast-enhanced CT (CE-CT). Materials and methods Eighty-two patients (7.0%) who underwent TAE after partial nephrectomy were reviewed, from 1166 partial nephrectomies performed over 6 years. In 18 patients (22.0%), TAE was performed emergently on the median postoperative day (POD) seven. In the remaining patients, elective TAE was performed on the median POD six for RAP detected by early postoperative CE-CT or that emerged on follow-up CE-CT. Results In one patient (1.2%), TAE was performed twice because one of two RAPs could not be embolized during the first TAE, being successfully embolized at the second TAE after readmission with hematuria. Otherwise, no bleeding recurrence or RAPs were observed during the median 1354 follow-up days. Thus, the primary and secondary success rates of TAE were 98.8% (81 of 82 patients) and 100% (82 of 82 patients), respectively. On angiography, the average number of lesions was 1.7 ± 0.9 and the average RAP size was 12.8 ± 6.0 mm. The shapes of the lesions varied: oval-round 60, oval-round + AVF 36, irregular + AVF 14, AVF 12, irregular 10, disruption 4, and extravasation 3. No major complications were observed. The median inpatient days after TAE were two. No estimated glomerular filtration rate deterioration was observed (64.6 ± 18.6 vs. 64.2 ± 18.4 mL/min/1.73 m2, p = 0.902). Conclusion TAE is largely effective and safe for treating bleedings or RAPs, including AVFs, after partial nephrectomy, as screened by early postoperative CE-CT.

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“…Spontaneous rupture of the renal artery is a rare but documented event, and is usually preceded by pseudoaneurysmal formation. 9 , 10 The underlying etiology behind it can vary and has been reported to occur in various clinical scenarios including angiomyolipomas, renal cell carcinoma, acquired cystic kidney disease secondary to hemodialysis, a complication of surgery, or percutaneous procedures or preceded by an RAA. 10 - 16 …”

Section: Discussionmentioning

confidence: 99%

Renal Artery Rupture in Association With Fibromuscular Dysplasia

Akel

El‐Sayegh

2018

Journal of Investigative Medicine High Impact Case Reports

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Fibromuscular dysplasia is a noninflammatory arteriopathy of unknown etiology that affects medium-sized arteries. Although patients affected with it are often asymptomatic, some might have recurrent catastrophic events that depend mainly on the arterial bed involved. The most worrisome vascular complications of the disease are aneurysmal rupture and arterial dissection. Herein, we report a case of a 49-year-old woman who presented with sudden-onset abdominal pain without any inciting factors. She was found to have active blood extravasation from a capsular branch of the renal artery that happened spontaneously. Angiography revealed fibromuscular dysplasia in the renal arteries without any obvious aneurysms. To our knowledge, this is the first case in the literature describing such an event. In this article, we also review the possible underlying pathology behind such an event.

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Conservative management of renal artery pseudoaneurysm following partial nephrectomy

Cited by 8 publications

References 6 publications

Intraparenchymal renal artery pseudoaneurysm following nephrostomy tube insertion in a patient with a solitary kidney: A case report

Intraparenchymal renal artery pseudoaneurysm following nephrostomy tube insertion in a patient with a solitary kidney: A case report

Mid-term outcome of transarterial embolization of renal artery pseudoaneurysm and arteriovenous fistula after partial nephrectomy screened by early postoperative contrast-enhanced CT

Renal Artery Rupture in Association With Fibromuscular Dysplasia

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