Techniques and Strategies for the Endovascular Treatment of Renal Artery Aneurysm

Abstract

ABSTRACT Background Renal artery aneurysms are rare and constitute a challenge to endovascular treatment. Our objective was to describe and analyze the techniques and strategies for the endovascular treatment of renal artery aneurysms verifying short and medium-term results in a consecutive series of cases. Methods Retrospective study of procedures performed from January 2010 to December 2013, analyzing technical and therapeutic success, morbidity and mortality, the rate of endoleaks and reinterventions. Results In a total of six patients treated, mean age was 41 ± 5 years and all patients were female. The majority of the patients had type 2 saccular aneurysms (83.3%). Remodeling techniques using stent and coils were used in four cases; embolization of renal polar branch was used in one case and treatment with a Multilayer® endoprosthesis in another case. Technical and therapeutic success rates were 100% and 83.3%, respectively. In one patient there was upper renal pole ischemia, which progressed to uncontrollable hematuria and pain, requiring nephrectomy. There were no deaths or occlusion of the native renal artery and its branches during the 1-year follow-up. Conclusions Endovascular treatment of renal artery aneurysm proved to be a feasible alternative to conventional surgery with low morbidity. A detailed study of renal vasculature and aneurysm location determines the choice of the endovascular technique to be used. Type II renal artery aneurysm was the most frequent morphology observed and may be successfully treated by remodeling techniques using stents and coils.