Endovascular Techniques for the Treatment of Renal Artery Aneurysms

Elaassar, Omar; Asselineau, Julien; Marquez, Romero; Tall, Philippe; Rousseau, Hervé; Joffre, Francis

doi:10.1007/s00270-011-0127-9

Cited by 42 publications

(40 citation statements)

References 32 publications

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“…These procedures are technically challenging, have a not negligible mortality, morbidity rates of 0-28% and imply prolonged recovery periods. Other potential risks include unplanned nephrectomy, branch occlusion, ureteral stricture, postoperative graft occlusion and postsurgical arterial stenosis [11, 12]. For these reasons, during the past decade different endovascular procedures have been proposed as an alternative to surgery.…”

Section: Discussionmentioning

confidence: 99%

“…Type 1 RAAs include saccular aneurysms arising from either the main renal artery trunk or proximally from a large segmental branch. The relationship between the size of the aneurysm and the diameter of its neck is the most important factor driving the selection of the treatment for both cerebral and renal malformations, a treatment that is mainly based on coils embolization [12, 13]. Fusiform RAAs (type 2) cannot be treated with coils embolisation but they are eligible for covered-stent, a treatment that can be combined with PTRA in case of arterial stenosis.…”

Section: Discussionmentioning

confidence: 99%

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An Unusual Case of Fibromuscular Dysplasia with Bilateral Renal Macroaneurysms: Three-year Outcome After Endovascular Treatment

Buso¹,

Rattazzi²,

Leoni³

et al. 2013

TOCMJ

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Fibromuscular dysplasia (FMD) is an idiopathic, segmental, non-inflammatory and non-atherosclerotic disease that affects arterial walls, leading to stenosis of small and medium-sized arteries. FMD mostly involves renal and intracranial arteries and only in few patients is associated with macroaneurysms (RAAs). We present the case of a 45-years old woman with recent history of grade 2 hypertension that suffered of subarachnoid haemorrhage due to rupture of a basilar artery aneurysm. The cerebral aneurysm was immediately treated by coil embolization and an abdominal angio-CT scan was performed to investigate the presence of renovascular hypertension. The exam showed the presence of FMD of the renal arteries associated with presence of bilateral RAAs. Due to the high risk of rupture, the bigger aneurysm (2,5 cm diameter) present on the left artery was immediately treated by coil embolization. The fusiform aneurysm, present on the right renal artery, was instead treated one year later by using two flow diverter stents. After three years, an angiographic study showed that both cerebral and renal aneurysms were excluded from the blood flow without evidence of arterial restenosis.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

An Unusual Case of Fibromuscular Dysplasia with Bilateral Renal Macroaneurysms: Three-year Outcome After Endovascular Treatment

Buso¹,

Rattazzi²,

Leoni³

et al. 2013

TOCMJ

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“…However, it remains essential to identify secondary treatable causes of raised blood pressure like RVD in this age group. RAAs are an uncommon cause of disease of the renal vessels with reports estimating a prevalence of 0.01–1% in the general population though their true prevalence is uncertain 5 6. Rarely, RAAs are idiopathic but, more often, an underlying cause can be identified.…”

Section: Discussionmentioning

confidence: 99%

“…Other options include using endovascular intervention which has been used successfully to treat adult patients with RVD and is increasingly being used in the paediatric population 4 6 13. There is also a large cohort of paediatric patients with RAS, described in the literature, who have undergone numerous different surgical procedures including resection and reimplantation, bypass using veins or arteries as grafts or primary nephrectomy 14.…”

Section: Discussionmentioning

confidence: 99%

Hypertension, secondary to a renal artery aneurysm, treated by ex vivo aneurysm repair and autotransplantation

2012

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Hypertension is becoming a more common problem in childhood and adolescence. About 5-10% of paediatric patients with hypertension have underlying renovascular disease. Although renal artery aneurysms (RAAs) are an uncommon cause of disease of the renal vessels, they are recognised as a cause of hypertension. We describe a 15-year-old man with symptomatic hypertension who after extensive investigation was found to have a right RAA. Our patient responded to conservative management with two antihypertensive agents, but as a young sports enthusiast, he was keen to pursue more definitive options. Complex anatomy of the aneurysm precluded the use of endovascular treatment. Surgical options were explored, and after counselling, our patient underwent a nephrectomy, ex vivo aneurysm repair and autotransplantation with which his hypertension resolved. Our case highlights the difficulty of diagnosing RAAs in hypertensive patients and that, in carefully selected patients, invasive surgical intervention of RAAs is a viable treatment option.

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“…1,2 While the short-term success rates of these techniques are satisfactory, long-term results remain unclear and periodic imaging surveillance is essential. This is generally performed by computed tomography (CT) or magnetic resonance imaging (MRI).…”

mentioning

confidence: 98%

Surveillance of a coiled renal artery aneurysm by contrast-enhanced ultrasound with Definity

Low

Winters

Owen

2011

Journal of Vascular Surgery

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Imaging surveillance is necessary to assess for long-term procedural outcomes after endovascular treatment. This is generally performed by computed tomography (CT) or magnetic resonance imaging (MRI). Contrast-enhanced ultrasound (CEUS) has recognized utility for cardiovascular and abdominal applications and is an alternative option in patients with renal impairment or CT/MR contrast-related reactions. We believe that we present the first reported case of CEUS in the surveillance of a treated renal artery aneurysm. The 57-year-old patient had a severe CT contrast allergy. CEUS performed with Definity microbubble ultrasound contrast (Lantheus Medical Imaging, Billerica, Mass) was well tolerated and showed no residual filling of the aneurysm.

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Endovascular Techniques for the Treatment of Renal Artery Aneurysms

Abstract: Ten different determinants were found to affect our decision making: shape, size, neck, position of aneurysm on artery, branches arising, artery involved, condition of the artery, age, general condition of the patient, and renal function.

Cited by 42 publications

References 32 publications

An Unusual Case of Fibromuscular Dysplasia with Bilateral Renal Macroaneurysms: Three-year Outcome After Endovascular Treatment

An Unusual Case of Fibromuscular Dysplasia with Bilateral Renal Macroaneurysms: Three-year Outcome After Endovascular Treatment

Hypertension, secondary to a renal artery aneurysm, treated by ex vivo aneurysm repair and autotransplantation

Surveillance of a coiled renal artery aneurysm by contrast-enhanced ultrasound with Definity

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