Abstract No. 457 - Stent-assisted transcatheter coil embolization of wide-necked renal artery aneurysms

Abstract

We report treating wide-necked renal artery aneurysms (RAA) by stent-assisted coil embolization. We performed transcatheter coil embolization (TCE) in 19 patients. When the aneurysmal neck measures less than half of the short axis of the aneurysm we use sac packing only, when it measures more than half we perform stent-assisted coil embolization of the aneurysmal sac. Patients whose RAA was more distal on the renal artery than the bifurcation (n=12) underwent TCE by coil-packing the aneurysmal sac only. Single-stent-assisted coil embolization of the sac was used when the RAA was at the renal artery trunk or the distal renal artery (n=4), partial stent in stent-assisted coil embolization of the aneurysmal sac when the RAA was at the renal artery bifurcation (n=3). TCE was technically successful in all patients. However, in 2 of the 12 patients who underwent coil-packing of the sac only, the coils migrated into the distal renal artery, the native circulation was not preserved. One of 2 patients with fibromuscular dysplasia who was treated by partial stent in stent-assisted coil embolization manifested restenosis proximal to the stent; re-stenting was required to preserve the native arterial circulation. One patient treated by single-stent-assisted coil embolization showed coil compaction one year later and underwent re-intervention. There were no instances of further recurrence or ectopic RAA. Follow-up showed that none of the stents had broken or become occluded. TCE can be an effective treatment of RAA and stent-assisted TCE is technically feasible and effective for wide-necked RAAs.