Renal Artery Aneurysms: Natural History and Prognosis

Tham, Gunnar; Ekelund, Leif; Herrlin, Kristian; Lindstedt, E; Olin, Tord; Bergentz, Sven‐Erik

doi:10.1016/s0022-5347(17)51499-8

Cited by 55 publications

(91 citation statements)

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“…Increased interest in aneurysms involving the renal artery and its branches has occurred during the past 3 decades [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15]. The prevalence of renal artery aneurysms is approximately 0.01%-1% in the general population as well as 2.5% in hypertensive patients undergoing angiography.…”

Section: Introductionmentioning

confidence: 99%

Intraparenchymal renal artery aneurysms. Case report with review and update of the literature

Porcaro¹,

Migliorini²,

Pianon³

et al. 2004

Int Urol Nephrol

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Increased interest in aneurysms involving the renal artery and its branches has occurred during the past 3 decades. The prevalence of renal artery aneurysms is approximately 0.01%-1% in the general population as well as 2.5% in hypertensive patients undergoing angiography. Intraparenchymal renal artery aneurysms (IPRAAs) are rare since being detected in less than 10% of patients with renal artery aneurysms. The Authors report an unusual case of multiple small intrarenal artery aneurysms associated with a large IPRAA located in the mid portion of the right kidney. Usually, IPRAAs are secondary to diseases or injuries of the kidney vascular network. They are classified as true, false, saccular, fusiform, dissecting, and microaneurysms. Potential complications of IPRAAs include peripheral dissection, thrombosis, hypertension, renal infarction and rupture. IRAAs may be detected incidentally as well as present with urologic symptoms and signs related to complications. Actually, IRAAs are investigated by non invasive modalities including duplex ultrasound, magnetic resonance angiography, spiral three-dimensional computed tomography angiography, and three-dimensional reconstructed rotational digital substraction angiography of the segmental and distant branches of the renal artery. Angiography with intrarterial injection of contrast material is the gold standard in diagnosing IPRAAs. Treatment options for IPRAAs include observation, aneurysmectomy with surgical repair, endovascular procedures, nephrectomy or partial nephrectomy. Observation is indicated for asymptomatic intraparenchymal renal artery aneurysms measuring less than 2 cm in diameter. Surgical repair of IPRAAs includes aneurysmectomy and reconstruction of the renal artery by in vivo or ex vivo technique. The procedure is indicated for IPRAAs causing renovascular hypertension, dissection, urologic symptoms, embolization, local expansion and women of childbearing age with a potential for pregnancy. In recent years, transcatheter arterial embolization has emerged as a simple, useful and effective technique in managing IRAAs. The procedure is performed by transfemoral catheterization as well as by superselective catheterization and embolization of interlobar arteries with 3F microcatheters. Endovascular occlusion is obtained by using gelatin sponge, steel coils, detachable baloons, and conventional non-detachable microcoils delivered through a microcatheter. Nephrectomy or partial nephrectomy are reserved for conditions precluding renal revascularization which include overt RAA rupture, covert RAA rupture, artery-to-vein fistula, renal cell carcinoma, end stage nephropaty, renal infarction, severe ischemic renal atrophy or complex intrarenal aneurysms. Recently, partial nephrectomy by the laparoscopic approach has been proposed for managing IPRAAs and the procedure is considered feasible and safe.

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Section: Introductionmentioning

confidence: 99%

Intraparenchymal renal artery aneurysms. Case report with review and update of the literature

Porcaro¹,

Migliorini²,

Pianon³

et al. 2004

Int Urol Nephrol

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“…The mortality of the subset of patients presenting aneurysm rupture is high, reaching 80% in most studies. 8 The clinical picture is variable including hypertension, hematuria, flank pain, and spontaneous rupture. 5,9 Hypertension is observed in 55%-75% from such patients and may be due to stenosis, parenchymal compression, and segmental ischemia.…”

Section: Discussionmentioning

confidence: 99%

Rupture of a Saccular Renal Artery Aneurysm: Report of a Case

2002

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This paper reports a patient who was successfully treated for a ruptured renal artery aneurysm. A 64-year-old man presented with sudden onset of strong abdominal and lumbar pain, and a 2-week history of abdominal discomfort. Abdominal computed tomography and visceral arteriography revealed a retroperitoneal hematoma and a 7.5-cm saccular renal aneurysm with active bleeding. A laparotomy was indicated, and a nephrectomy was performed due to the persistent bleeding and refractory hypotension presented during surgery. The postoperative course was uneventful, and the patient was discharged with a normal renal function on the tenth day. This paper presents the successful management of a ruptured renal aneurysm with a review of the literature, and the management possibilities of such patients is also discussed.

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“…Primary renal artery aneurysms are relatively rare, with an incidence estimated between 0.1%-2.5% in angiographic series (up to 9.7% in autopsy series) [1,2]. Aneurysms of the renal artery may constitute up to 25% of all visceral artery aneurysms [1,3].…”

Section: Discussionmentioning

confidence: 99%

“…Aneurysms of the renal artery may constitute up to 25% of all visceral artery aneurysms [1,3]. Tham et al [1] reported a large series from Sweden of 8,525 renal arteriograms in which 83 patients had renal aneurysms (bilateral in 6 patients and multiple in 11 patients). They also noted that most of these cases were discovered during the fourth to sixth decade of life and were equally distributed between males and females.…”

Section: Discussionmentioning

confidence: 99%