Giant Renal Artery Aneurysm Research Articles

Giant renal artery aneurysm with severe compression of the right kidney.

Renal artery aneurysm (RAA) is a rare condition among visceral aneurysms, often asymptomatic and incidentally discovered through imaging. Surgical or interventional procedures are utilized for treatment, depending on the aneurysm's size, morphology, and the patient's physical condition, to prevent rupture. A patient was admitted with a giant asymptomatic RAA, measuring a maximum diameter of 11cm on a serendipitous occasion. We successfully accomplished a full embolization treatment for the aneurysm, exclusively utilizing inflow tract embolization techniques. Six months post-treatment, a follow-up abdominal ultrasound examination demonstrated a notable decrease in the aneurysm's diameter, signifying the positive outcome of our intervention. This approach offers a feasible alternative in challenging cases, especially when traditional surgical methods are not feasible or carry significant risks.

Management of a Giant Renal Artery Aneurysm in a Patient with Severe Hemophilia A

Patient: Male, 54-year-old Final Diagnosis: Giant right renal artery aneurysm Symptoms: Bilateral leg edema Medication: — Clinical Procedure: — Specialty: Hematology • Radiology • Urology Objective: Rare coexistence of disease or pathology Background:Classical hemophilia, or hemophilia A, is an X-linked recessive genetic disorder characterized by deficiency in clotting factor VIII. Renal artery aneurysms (RAAs) are also rare and are defined as a focal dilatation of the renal artery that exceeds 1.5 cm in diameter. These 2 rare conditions – giant RAA and hemophilia A – were simultaneously observed in our patient. This report presents a male patient with hemophilia A with a 10-cm aneurysm of the right renal artery, which was treated with transarterial coil embolization and factor VIII infusion. The giant RAA was an incidental finding and was suspected after the abdominal ultrasound (US).Case Report:We present the case of a 10-cm right RAA in a 54-year-old man with hemophilia A. The patient had a congenital severe coagulation factor VIII deficiency (hemophilia A). He presented at a routine hematologist visit with an atypical symptom of severe symmetrical leg edema. Laboratory tests showed increased levels of creatinine and proteinuria. Investigations proceeded with computed tomography (CT) and digital subtraction angiography (DSA). Endovascular coiling of the aneurysm was performed with perioperative recombinant coagulation factor VIII substitution, and the recovery was uneventful. At 6-year follow-up there are no signs of proteinuria, and kidney function was stable.Conclusions:We present a case of renal artery aneurysm effectively treated by endovascular embolization, showing the importance of managing patients with hemophilia A according to a guidelines-based multidisciplinary approach and ensuring the lowest possible risk of peri- and intraoperative complications by using minimally-invasive treatments.

Endovascular treatment of a giant renal artery aneurysm.

Endovascular treatment of a giant renal artery aneurysm.

Percutaneous intervention treatment of giant extrarenal aneurysm arteriovenous fistula

Objective: Anteriovenous fistula is a high-flow vascular malformation. Anteriovenous fistula is characterized by a direct connection between an artery and a vein without the presence of a nidus (network of arterial and venous channels). Renal artery aneurysm concomitant with a renal arteriovenous fistula is extremely rare. Case report: We reported the case of a 45-year-old female who has giant renal artery aneurysm combined with high-flow RAVF who presented with gross hematuria. The patient’s embolization of a giant extrarenal aneurism arteriovenous fistula was successfully treated using specialized coils and plug device. Conclusions: Renal arteriovenous fistula is a disease that can lead to serious complications. Treatment of this condition should be initiated promptly after diagnosis. Embolization endovascular is a feasible, efficient and safe method which can maximally retain normal renal function.

Treating a thrombotic giant dissecting renal artery aneurysm through ex-vivo vascular reconstructive surgery followed by kidney reimplantation

Renal artery aneurysms, although rare, may give rise to complications both per se (due to the risk of thrombosis and subsequent wall rupture) and by impairment of the renal function (due to extrinsic compression and high blood pressure). We describe a paucisymptomatic young patient with acute thrombosis of a massive dissecting renal artery aneurysm, for which the successful treatment was performed through ex-vivo vascular surgery followed by autotransplantation of the reconstructed kidney. The aneurysm was described through abdominal echography, computed tomography angiography, and transfemoral transcatheter arterial angiography. It originated from an atypical branch emerging at 90 degrees from the left renal artery. After a short branching off, it degenerated into a dissected aneurysmal sac as large as half a kidney (outer diameter of 60 mm), compressing the lower pole of the left kidney and delaying the lower half nephrogram. Ex-vivo surgical exclusion of the aneurysm was successfully performed. The kidney was reimplanted in the left iliac fossa (termino-lateral anastomosis between the renal artery and external left iliac artery, termino-terminal ureteric anastomosis) with excellent postoperative outcomes. For most asymptomatic aneurysms, expectant treatment is a reasonable approach. However, interventional or surgical repair is indicated in certain circumstances depending on the size of the aneurysm and its natural history, rupture risk, and interventional/surgical risks. The renovascular hypertension, dissecting and thrombotic events, its giant size, the young fertile age, and the presence of the flank pain were all indicative of the need for aneurysm exclusion in our case.

Coil Embolization of a Giant Renal Artery Aneurysm

Renal artery aneurysms (RAAs) are rare but harbor serious consequences if they rupture. When determining if a RAA should be treated, physicians consider aneurysm size as it pertains to the likelihood of rupture. Giant RAAs have rarely been reported in the literature and have usually been managed by open aneurysmectomy and nephrectomy. In the present case, we report a 63year-old male incidentally found to have a giant aneurysm of his right segmental and interlobar arteries on computed tomography (CT). The patient underwent successful uncomplicated transcatheter coil embolization of his aneurysm and maintained no flow into the aneurysm with normal renal function seven years following the procedure.

Giant Renal Artery Aneurysms: Decision-Making Dilemmas

A case of a 10 cm giant renal artery aneurysm in an 81-year-old lady is herein reported. The patient presented as an incidental finding on an abdominal ultrasound with an aneurysm which was large, soft, egg-shell-like, and bilobular with a cauliflower-type pattern invading the parenchyma of the renal substance and extending caudally. A right nephrectomy was carried out, and the patient made an uneventful recovery. This paper reviews the options for treatment of giant renal artery aneurysms and highlights the benefit of a planned nephrectomy once there is adequate renal reserve in the opposite kidney using a midline approach for right-sided giant renal artery aneurysms and a left-sided flank approach for left-sided aneurysms.

Giant Calcified Renal Artery Aneurysm: Traditional RX versus Three-Dimensional Computed Tomography

A 65-year-old woman with no history of previous flank trauma, renal stone or upper urinary tract infections, presented for flank pain and left hydro-uretero-nephrosis seven days after hysterectomy. Percutaneous pielography revealed narowing of the distal ureter, without endoureteral mass. The plain abdomen film incidentally showed a 3-cm calcified ring on the left renal shadow, who resulted external to the collecting system at pielography. A 3-dimensional-CT scan with angiographic reconstruction revealed a 3-cm calcified renal artery aneurysm. The vascular surgeon suggested a watchful waiting. The patient underwent ureteral reimplantation with ureteral stenting, allowing a complete recovery of iatrogenic stenosis two months postoperatively.

Surgical Treatment of a Ruptured Giant Renal Artery Aneurysm - Case Report and Literature Review

Renal artery aneurysms are the second most common visceral artery aneurysms after splenic artery aneurysms, and before hepatic artery aneurysms. The study presented a case of a ruptured giant right renal artery aneurysm in a female patient. The presented case is worth mentioning, due to the giant size of the lesion. The diameter of the aneurysm exceeded 10 cm. Available literature data mentioned single reports of such large aneurysms located in the renal arteries. In spite of the fact that renal artery aneurysms are the second most common visceral artery aneurysms, their management is accompanied by some controversy. Literature data mentioned the dominance of endovascular techniques. However, surgical treatment remains to be the most effective and radical method.

Staged coil embolization of extraparenchymal giant renal artery aneurysm with preservation of renal function

A 9-cm renal artery aneurysm near the primary bifurcation of the left main renal artery, which caused ischemic change and a small infarction in left renal anterior segment, was treated with staged coil packing of the aneurysm. Initial embolization with deployments of twelve 0.035-in. coils resulted in partial occlusion of the aneurysm and thickening aneurymal wall. Three months later after the initial embolization, packing of twenty-six 0.018-in. detachable coils achieved in occlusion of the aneurysm preserving contrast flow in near the neck and the posterior segmental artery. Both 3- and 1-year follow-up computed tomographic images, after the second session, confirmed no contrast flow in the aneurysm with restored contrast flow in the left kidney. This case indicates that staged coil embolization may be alternative to nephrectomy in patients with extraparenchymal giant renal artery aneurysms.

Surgical Repair of a Giant Renal Artery Aneurysm: A Case Report

A case of a giant renal artery aneurysm and multiple small branch aneurysms in a 48-year old man is presented. The largest aneurysm was repaired successfully with kidney preservation. Small branch aneurysms were left alone. Subsequent CT scans 6, 12 and 20 months after the operation revealed the same aneurysms without any increase in size and shape.

Multidetector spiral CT renal angiography in the diagnosis of giant renal artery aneurysms

A case of giant renal artery aneurysm in a 63-year-old man is presented. Renal artery aneurysms are rare (incidence of <1%) and this case is one of the largest giant renal artery aneurysms recorded in the literature. This case also demonstrates the value of multidetector spiral CT renal angiography (CTA) in the diagnosis, planning and treatment of renal aneurysms.

Giant renal aneurysm with arteriovenous fistula

A hypertensive 78-year-old woman was admitted with continuous abdominal pain and nausea and was diagnosed with right giant renal artery aneurysm (RAA; 70 mm in diameter) by means of abdominal computed tomography. Aortography demonstrated huge RAA with arteriovenous fistula visualizing the inferior vena cava at arterial phase. Nephrectomy was performed and the patient has had an uneventful postoperative course.

Multidetector spiral CT renal angiography in the diagnosis of giant renal artery aneurysms

A case of giant renal artery aneurysm in a 63-year-old man is presented. Renal artery aneurysms are rare (incidence < 1%) and this case is one of the largest giant renal artery aneurysms recorded in the literature. This case also demonstrates the value of multidetector spiral computed tomographic renal angiography in the diagnosis, planning, and treatment of renal aneurysms.

Major renal artery aneurysm as cause of hydronephrosis treated by renal preservation surgery

We report a case of a giant renal artery aneurysm causing hydronephrosis that initially had erroneously been thought to be a renal cyst. Giant renal artery aneurysms greater than 10 cm in diameter are very rarely reported. The aneurysm was repaired successfully with kidney preservation and closure of the arterial fistula.

Giant renal artery aneurysm

A hypertensive 67-year-old woman was admitted with a large, non-tender abdominal mass that caused a gross bulging of the abdominal wall. The patient was symptom-free except for occasional low back pain. She had been aware of the mass for over 5 years, but had not sought medical attention. Her family history was negative for significant vascular pathology. She had no history of trauma or instrumentation. Renal function was normal. Computed tomography scan (Cover) showed a giant aneurysm of the left renal artery (diameter 25 cm). The wall was calcified; thrombosis was extensive, but incomplete and dyshomogenous. The abdominal organs were dislodged to the right. No other aneurysmal locations were disclosed. Magnetic resonance angiography (A) showed the origin of the lumen of the aneurysm to be in the mid-left renal artery. Surgery was performed through a transverse laparotomy. The gastrocolic ligament was incised and the anterior wall of the aneurysm exposed and incised (B). The thrombus was removed from the sac and the origin of the aneurysm from the left renal artery exposed (C, arrow). A breach in the arterial wall was visible. The unclamped artery was digitally compressed for hemostasis while the artery was closed primarily. Pathologic examination confirmed a true atherosclerotic aneurysm. The patient is alive and well 6 months after the operation, with normal renal function. Aneurysms of the renal artery may occasionally reach large dimensions, but this case must be considered exceptional. It is actually extremely uncommon for aneurysms in any location to reach this size without rupturing. Giant renal artery aneurysms ( 5 cm. diameter) have been reported in fewer than 20 cases in the English literature. They may be pseudoaneurysms, usually secondary to invasive procedures such as percutaneous transluminal angioplasty or pyelolithotomy, or true aneurysms, often with parietal calcifications. The principal justifications for surgical treatment are ureteral obstruction, hypertension, pain, and elimination of the risk for rupture. Repair may require arterial reconstruction or even nephrectomy, but may also require only simple closure of the artery defect, as was possible here.

Giant Renal Artery Aneurysms

Renal artery aneurysms (RAAs) are rare, relatively small, and do not need to be treated in most instances. Giant RAAs (&gt; 5.0 cm in diameter), however, may require a different approach. Two women, both 75 years old, were treated at the authors' institution for giant RAAs. One patient, with a single kidney, was diagnosed with acute renal failure as a result of ureteral obstruction by a 6.0-cm RAA. The other RAA was found incidentally on a plain abdominal radiograph performed for right flank pain; severe hypertension was present in this patient. Computerized tomography (CT) scan in this patient demonstrated a left RAA with a maximal diameter of 6.5 cm. Arteriography was obtained in both patients. Both aneurysms were located adjacent to the hilum of the kidney arising from a major branch of the main renal artery near the branch's origin. Both had evidence of partial calcification within the wall. The patients were treated surgically with partial excision and ligation. In the first patient, surgery was necessary to relieve ureteral obstruction, whereas hypertension control was the main goal in the other. The patients did well with maintenance of renal function postoperatively. Giant RAAs may cause pain, obstruction of the ureter, or renal vascular hypertension. Resolution of these symptoms can be expected with proper surgical intervention as well as elimination of the potential risk for rupture.

Renin-Dependent Hypertension in a Case with a Giant Renal Artery Aneurysm

Renin-Dependent Hypertension in a Case with a Giant Renal Artery Aneurysm