Endovascular treatment of wide-neck saccular renal artery aneurysm with waffle-cone technique.

Paulo Eduardo Ocke Reis,Guilherme De Palma Abrão,Leonardo Roever

doi:10.1590/1677-5449.200116

Abstract

In the past, treatment of visceral artery aneurysms (VAAs) was exclusively surgical. These aneurysms were rarely diagnosed in elective or emergency cases. Development of imaging techniques and endovascular procedures has changed the history of the therapeutic options for this pathology. Endovascular management of VAAs has arisen to advances in endovascular techniques and has achieved high efficacy.

Highlights

In the past, treatment of visceral artery aneurysms (VAAs) was exclusively surgical, using open approaches, until development of imaging techniques and endovascular devices expanded the treatment options.[1,2] The key to success is to choose the best technique for each case individually
First conceived in neuro-interventional practice, the differentiating factor with this technique is that it uses the stent as support to guide positioning of the coils to prevent prolapse during deployment and to help packing, resulting in a stable scaffold jailing the coils in the aneurysm sac.[2,3,4,5,6,7,8]
The diameter of the nitinol stent is determined based on assessment of the size of the aneurysm neck and the diameter of the proximal parent artery

Summary

INTRODUCTION

Treatment of visceral artery aneurysms (VAAs) was exclusively surgical, using open approaches, until development of imaging techniques and endovascular devices expanded the treatment options.[1,2] The key to success is to choose the best technique for each case individually. Digital subtraction angiography demonstrated complete occlusion of the aneurysm after stent assisted coiling (Figures 3 and 4). Final control arteriography demonstrated the aneurysm completely occluded (Figure 5). Control CT showed successful exclusion of a 2.7 x 2.0 cm saccular intraparenchymal renal aneurysm (Figure 6). The patient was given dual antiplatelet therapy after the procedure. She gave her consent to publication of her case details and images

PART I - CLINICAL SITUATION

PART II - WHAT WAS DONE

DISCUSSION