Endovascular Treatment of a Complex Renal Artery Aneurysm Using Coils and the Pipeline Embolization Device in a Patient with a Solitary Kidney

Adrahtas, Demetri; Jasinski, Patrick; Koullias, George J.; Fiorella, David; Tassiopoulos, Apostolos K.

doi:10.1016/j.avsg.2016.03.004

Cited by 12 publications

(9 citation statements)

References 13 publications

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“…Recently published results from the Fred Italian Registry Follow-up have shown complete or nearly complete occlusion of the aneurysm in 94% of cases at 3–6 months, increasing to 96% at 12–24 months’ follow-up. The use of cerebral FDS for the treatment of hepatic, renal and other VAA and VAP has been reported since 2012, with good clinical outcomes (Hardman et al 2015 ; Colombi et al 2018 ; Abraham et al 2012 ; Adrahtas et al 2016 ; Maingard et al 2019 ; Shlomovitz et al 2011 ). Similarly to the results of those reports, in this series the stent primary and assisted primary patency at 1-year were 83.3% and 100%, and all aneurysms showed dimensional reduction varying from 12.5 to 100% (mean 55.8%).…”

Section: Discussionmentioning

confidence: 99%

“…Although these devices were primarily designed for use in intracranial circulation, cerebral FDS could hypothetically be employed to treat morphologically complex aneurysms, regardless of their location (Sfyroeras et al 2012 ). The use of a variety of flow diversion techniques for the treatment of VAA and VAP has recently been reported, with good results in terms of stent patency and aneurysm sac reduction rates (Hardman et al 2015 ; Colombi et al 2018 ; Abraham et al 2012 ; Adrahtas et al 2016 ).…”

Section: Introductionmentioning

confidence: 99%

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Treatment of visceral artery aneurysms and pseudoaneurysms with the use of cerebral flow diverting stents: initial experience

et al. 2020

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Background: Flow-diverter stents (FDS) are designed to maintain laminar flow in the parent artery and sidebranches and to promote thrombosis of the aneurysm. Although these devices were developed for use in intracranial circulation, FDS could be employed to treat aneurysms regardless of their location, when anatomic factors may limit the efficacy of classic endovascular techniques. The objective of this study is to describe the initial experience of a single center in the treatment of visceral artery aneurysms and pseudoaneurysms (VAA-VAP) with cerebral FDS, analyzing safety, efficacy and 1-year outcome. Between 2016 and 2018 six patients (4 women, mean age 57.6) underwent treatment with FDS of 4 VAA and 2 VAP located in renal (4), hepatic (1) and splenic arteries (1). Mean aneurysm diameter was 14.3 mm (range 8-22). All the aneurysms had sidebranches arising from the neck or had an unfavorable dome-to-neck ratio. Technical success, safety, efficacy and 1-year outcome were analyzed. Follow-ups (FU) with Color-Doppler US and CTA ranged from 12 to 36 (mean 20) months. Results: Technical success was achieved in all cases. There were no aneurysm rupture nor reperfusion after exclusion. Five out of six (83.3%) FDS were patent at each FU; all the aneurysms showed shrinkage with a mean dimensional reduction rate of 55.8%. Sac thrombosis was observed in 4 aneurysms at 1 (n = 3) and at 12-month FUs. There was one sidebranch occlusion with evidence of a small area of kidney hypoperfusion at the 12-month FU, which was asymptomatic. In one patient, a reintervention was needed because CTA showed a severe in-stent stenosis, which was symptomatic. Mean hospitalization was 4.1 days. Conclusions: Treatment of morphologically complex VAA and VAP with cerebral FDS proved to be safe and efficient. Stronger evidence from larger populations are required.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Treatment of visceral artery aneurysms and pseudoaneurysms with the use of cerebral flow diverting stents: initial experience

et al. 2020

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“…For patient 3, we reported the successful endovascular management of an RAA in a solitary functioning kidney. Three previous cases of management of an RAA in a solitary kidney have been reported, including the use of a pipeline embolization device, 14 balloon-assisted coil embolization, 11 and a robotic surgical technique with partial RAA excision and tailored repair. 15 Our report of an RAA in a single functioning kidney has demonstrated successful management with the double catheter embolization technique.…”

Section: Discussionmentioning

confidence: 99%

Endovascular coiling in the treatment of patients with renal artery aneurysms

Finch

Spiers

Chinnadurai

et al. 2021

Journal of Vascular Surgery Cases, Innovations and Techniques

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This is a PDF file of an article that has undergone enhancements after acceptance, such as the addition of a cover page and metadata, and formatting for readability, but it is not yet the definitive version of record. This version will undergo additional copyediting, typesetting and review before it is published in its final form, but we are providing this version to give early visibility of the article. Please note that, during the production process, errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.

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“…1) a wide aneurysm neck, making it higher risk for branch artery occlusion during embolization and subsequent renal infarction [13,14];…”

Section: Treatment and Prognosismentioning

confidence: 99%

Endovascular repair of a complex renal artery aneurysm using Pipeline (TM) Embolization Device (PED) assisted coil embolization

Liang¹,

Duckwiler²,

Middleton³

et al. 2021

Radiology Case

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Background: We describe the treatment of a renal artery aneurysm with complex anatomy using coils and the Pipeline (TM) Embolization Device (Medtronic, Irvine, CA), a flow-diverting stent typically used for the treatment of intracranial aneurysms. Methods: A 62-year-old female with history of an asymptomatic right renal artery aneurysm that was discovered incidentally 10 years ago was found to have enlargement of the aneurysm (1.9cm to 2.7cm) on a repeat surveillance CT scan. She was successfully treated with combined Pipeline Embolization Device and coil embolization of the aneurysm sac. Results: Post-procedural angiography showed complete occlusion of the aneurysm with maintenance of perfusion to the entire kidney. Conclusion: Pipeline (TM) assisted coil embolization may be an option for parenchyma-sparing treatment of renal artery aneurysms with complex anatomy.

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Endovascular Treatment of a Complex Renal Artery Aneurysm Using Coils and the Pipeline Embolization Device in a Patient with a Solitary Kidney

Cited by 12 publications

References 13 publications

Treatment of visceral artery aneurysms and pseudoaneurysms with the use of cerebral flow diverting stents: initial experience

Treatment of visceral artery aneurysms and pseudoaneurysms with the use of cerebral flow diverting stents: initial experience

Endovascular coiling in the treatment of patients with renal artery aneurysms

Endovascular repair of a complex renal artery aneurysm using Pipeline (TM) Embolization Device (PED) assisted coil embolization

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