Stent-assisted coil embolization of a wide-necked renal artery aneurysm

Abstract

We present a case of stent-assisted coil embolization of a wide-necked renal artery aneurysm performed at our institution. The technique involved a stent being delivered over the neck of the aneurysm. Subsequently a catheter was placed into the aneurysm through the stent mesh and the aneurysm was then filled with detachable coils. Complete aneurysm occlusion was obtained and there was no evidence to suggest renal infarction on a follow-up contrast CT scan 6 months later. Our preliminary experience suggests that stent-assisted coil embolization of wide-necked renal artery aneurysms is a technically challenging but potentially effective renal-sparing endovascular approach.

A curable cause of hypertension: renal artery pseudoaneurysm

“…It is strongly suggested that aneurysms larger than 2 cm in size and all pseudoaneurysms should be treated due to the risk of lethal rupture of the sac, especially in women of childbearing age. However, true aneurysms less than 2 cm have a negligible risk of complications, and thus authors advise a follow-up with yearly imaging [1,4]. While the Rundback type I aneurysm is a candidate for treatment with a covered stent, Rundback type II and III aneurysms likely can be man- aged by the other techniques.…”

Técnicas e Táticas no Tratamento Endovascular do Aneurisma da Artéria Renal

“…18 Estudos com o tratamento endovascular desses aneurismas são restritos a casuísticas pequenas ou relatos de caso. [19][20][21][22][23] Antoniou e Antoniou 24 apresentaram revisão de 22 aneurismas tratados com uso de stents, com 91% de sucesso técnico e 27% de complicações menores, como a oclusão de pequenas artérias polares. Durante o seguimento de 8 meses, foi relatada uma reestenose da artéria renal.…”

“…Nesses casos, a utilização de técnicas de remodelamento com uso de stent, associada ao uso de molas, ou de molas e cola, é fundamental para a preservação dos vasos nativos e o correto selamento do aneurisma. 2,4,9,15,20 Quanto aos aneurismas do tipo III, que emergem a partir de pequenas artérias segmentares e suprem uma pequena parte do parênquima renal, podem ser embolizadas com a oclusão do vaso nutridor. Agentes líquidos, como a cola e o Onyx ® (Ev3 Inc., Plymouth, Estados Unidos), podem ser usados para esse propósito.…”

Técnica de remodelamento com uso de stents em T e molas para tratamento de aneurisma renal complexo

“…The number of cases diagnosed has been increasing because of wider use of imaging methods such as Doppler ultrasonography and computed tomography angiography (CTA). 1 , 2 …”

“…Indications for treatment and choice of technique are still controversial because of the small number of studies available, which is a consequence of the rarity of the disease, making it difficult to conduct randomized clinical trials. 2 , 3 Open surgery is one treatment option, with excision of the aneurysm and reconstruction or nephrectomy. 2 As endovascular techniques evolved, treatment of RAA using percutaneous repair became possible, offering reduced surgical trauma, shorter postoperative hospital stay, and lower morbidity, when compared to open surgical treatment.…”