Optimal surveillance and treatment of renal and splenic artery aneurysms

Wang, Tom Kai Ming; Desai, Milind Y.

doi:10.3949/ccjm.87a.19140-2

Cited by 11 publications

(7 citation statements)

References 14 publications

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“…However, the indications for RAA treatment remain controversial. Most surgeons generally believe that if the RAA is not ruptured, preventive surgical intervention is required if the following conditions exist: (1) large size (>2 cm), (2) symptoms, (3) refractory hypertension with significant renal artery stenosis or thromboembolism, (4) childbearing age (for women) (3,4,22). However, Lawrence et al (9) stated that surgery to prevent rupture of asymptomatic RAA with a defined >2 cm might be too aggressive because asymptomatic RAA rarely rupture and grow slowly.…”

Section: Discussionmentioning

confidence: 99%

“…The incidence of RAA in the general population and angiography and computed tomography (CT) research reports were 0.1% and 0.3%-2.5%, respectively. The incidence of RAA rupture is 3%-5% and the mortality rate after non-pregnant aneurysm rupture is approximately 10% (3,4). Massive hemorrhage caused by RAA rupture is a clinical emergency that requires urgent intervention.…”

Section: Introductionmentioning

confidence: 99%

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Eighteen cases of renal aneurysms: Clinical retrospective analysis and experience of endovascular interventional treatment

Lin

Zhang

et al. 2023

Front. Surg.

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BackgroundDevelopment of endovascular interventional techniques gradually replaced traditional open surgery and has become the preferred treatment for renal aneurysms. This study aimed to analyze the clinical characteristics of renal artery aneurysm (RAA) and the safety and efficacy of intravascular interventional treatment.Materials and MethodsWe retrospectively analyzed the clinical characteristics and imaging data of 23 aneurysms in 18 patients with RAA. The technical success rate, complication rate, mortality rate, reintervention rate, and use of embolization materials were evaluated.ResultsIn 18 patients with RAA (age, 32–72 years, average age, 52.2 ± 11.2 years), a total of 23 aneurysms were found (diameter 0.5–5.5 cm, average diameter 2.2 ± 1.4 cm). Among them, 11 cases (61.1%) were discovered accidentally, and the remaining patients were diagnosed due to the following major complaints: four cases (22.2%) presented low back pain, two (11.1%) were due to high blood pressure, and one (5.5%) had low back pain with gross hematuria. A total of 14 aneurysms in 13 patients received endovascular interventional therapy. The technical success rate of 13 patients with renal aneurysms was 100%. Three of the 18 patients were lost to follow-up, and the remaining were followed up for 4–89 months. There was no recurrence of the aneurysm or displacement of the stent or coil.ConclusionEndovascular treatment for RAA has a high success rate, low complication rate, and low reintervention rate. It has the advantage of less trauma and is flexible and more targeted for different types of renal aneurysms.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Eighteen cases of renal aneurysms: Clinical retrospective analysis and experience of endovascular interventional treatment

Lin

Zhang

et al. 2023

Front. Surg.

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“…Bearing in mind all of the above, and in the case when patient presents with one or several complications, physicians need to be aware of them and to act quickly, given a high mortality rate in case of rupture, which is up to 80% [17,18,19].…”

Section: Discussionmentioning

confidence: 99%

A rare case of spontaneous rupture of renal artery pseudoaneurysm in a previously hypertensive patient

et al. 2022

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Introduction. The renal artery and segmental renal artery pseudoaneurysm is a rare and usually asymptomatic vascular lesion which in most of the cases thrombose spontaneously, but at same time it can be a source of life-threatening hemorrhage and shock. Today, these pseudoaneurysms are discovered with increasing frequency due to unrelated abdominal imaging or on screening work-ups for hypertension, as well as widespread use of angiography. Typically, they are seen in patients after trauma, inflammation, or renal surgery or biopsy. Case outline. In our case, a 52-year-old male patient with no prior history of surgery, significant abdominal trauma and systemic disease, presented with left flank pain and signs of hypovolemic shock that manifested before the admission in the surgical emergency room. The CT scan promptly demonstrated rupture of large retroperitoneal hematoma with the massive intraperitoneal hemorrhage. The angiography confirmed the rupture of the renal artery pseudoaneurysm. The patient had the urgent operation. A life-saving nephrectomy was performed while intraperitoneal hemorrhage and retroperitoneal hematoma was evacuated. The fourteen days after surgery the patient was discharged fully recovered, with normal diuresis and serum levels of creatinine and urea within referential values. During the period of hospitalization, he was diagnosed and treated hypertension. Conclusion. Rupture of pseudoaneurysms with the following hemorrhage into the intraperitoneal cavity and retroperitoneum is a life-threatening condition, as proven with this case in which hypovolemic shock manifested before the admission. We would like to highlight the importance of high blood-pressure control and the importance of regular check-ups.

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“…The detection of its size or whether there is a rupture trend seems to be a time-consuming process. Aneurysm morphology is an essential factor for immediate intervention, but the patient's age, blood pressure, blood glucose, and childbearing age still need to be considered comprehensively [1,[9][10][11][12]. RAA-related mortality may be low in the general population, however, it can be higher in emergencies, such as a sudden increase in abdominal pressure [10].…”

Section: Discussionmentioning

confidence: 99%

Combination of Sac packing and liquid embolization using Double Microcatheter Technique for Renal Artery Aneurysm: A Case Report

Chen¹

2022

CTCMS

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Interventional radiology for a renal artery aneurysm. She had been suffering from functional constipation and gastric polyps for the last 8 years. A month ago, she went to the outpatient clinic for help with abdominal pain. An enhanced CT scan was performed for assessing suspected intestinal obstruction. A left hilum RAA measuring 23mm × 22mm in size was diagnosed incidentally. She had no history of microbial infections such as specific viruses. CTA examination suggested a regular and round saccular aneurysm with a narrow neck and a small branch on the sac (Figure 1). The abdominal pain significantly improved after symptomatic treatment. A month later, she was presented to the department of interventional radiology for a renal artery aneurysm. Although the abdominal pain was not

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Optimal surveillance and treatment of renal and splenic artery aneurysms

Abstract: The authors report no relevant fi nancial relationships which, in the context of their contributions, could be perceived as a potential confl ict of interest.

Cited by 11 publications

References 14 publications

Eighteen cases of renal aneurysms: Clinical retrospective analysis and experience of endovascular interventional treatment

Eighteen cases of renal aneurysms: Clinical retrospective analysis and experience of endovascular interventional treatment

A rare case of spontaneous rupture of renal artery pseudoaneurysm in a previously hypertensive patient

Combination of Sac packing and liquid embolization using Double Microcatheter Technique for Renal Artery Aneurysm: A Case Report

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