Wide-necked Renal Artery Research Articles

Balloon-assisted coil embolization (BACE) of a wide-necked renal artery aneurysm using the intracranial scepter C compliant occlusion balloon catheter

BackgroundTrue renal artery aneurysms (TRAA) are an uncommon pathology, with a prevalence of less than 1%. Treatment of TRAAs is generally recommended when the aneurysm sac equals or exceeds 2cms. Both wide-necked and main renal artery branch aneurysms represent a challenge for conventional endovascular coil embolization due to the risk of coil migration.Main bodyIntra-procedural remodeling of the aneurysm neck using Balloon Assisted Coil Embolization (BACE) is considered a suitable alternative in challenging cases of visceral artery aneurysms.Short ConclusionWe describe the novel use of the Scepter C (MicroVention Terumo, Tustin, CA) compliant double lumen neurovascular occlusion balloon in the treatment of a wide-necked branch TRAA in a patient with a solitary kidney.

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

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.

Treating coil migration in combination therapy involving stenting and coiling for a wide-necked renal aneurysm

A man with a wide-necked renal artery aneurysm underwent combination therapy involving stenting and coiling to embolize it. However, a large section of one of the coils had migrated outside the stent implanted across the orifice of the aneurysm. After repositioning the migrated coil inside the stent, the implantation of another stent together with sandwiching of the coil between two stents repaired the prolapsed coil. This report describes precautions that should be taken during combination therapy involving stenting and coiling to embolize a wide-necked aneurysm.

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

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.

Experiência preliminar com o uso da técnica de "remodelagem de colo" para tratamento endovascular de aneurismas complexos da artéria renal

OBJETIVO: Relatar os resultados preliminares da aplicação da técnica de "remodelagem do colo" no tratamento dos aneurismas de colo largo da artéria renal. MATERIAIS E MÉTODOS: Cinco pacientes (três mulheres e dois homens, com idade média de 62 anos, intervalo de 49-72 anos) com aneurismas da artéria renal variando de 10 a 25 mm de diâmetro, de colo largo, foram tratados com técnicas de embolização assistidas por "remodelagem do colo" com balão durante o período de três anos. O microbalão era posicionado diante do colo do aneurisma e insuflado, temporariamente, durante a colocação das micromolas destacáveis no interior do aneurisma. RESULTADOS: O posicionamento do balão e a colocação das micromolas foram realizados com êxito em todos os casos. Oclusão completa do aneurisma, sem protrusão de micromolas ou obstrução do vaso parental, foi alcançada em todos os pacientes. CONCLUSÃO: Nossa experiência preliminar indica que a aplicação da técnica de "remodelagem do colo" no tratamento dos aneurismas de colo largo da artéria renal é tecnicamente viável e eficaz para o tratamento endovascular de aneurismas complexos da artéria renal, sem o sacrifício de qualquer ramo arterial.

Stent-assisted Coil Embolization of Wide-necked Renal Artery Bifurcation Aneurysms

To report preliminary results of stent-assisted coil embolization in the treatment of wide-necked renal artery bifurcation aneurysms. Four patients (three women, one man; mean age, 54 years; range, 49-67 y) with wide-necked renal artery aneurysms were treated with dedicated neurointerventional self-expanding nitinol stent-assisted coil embolization during a 2-year period. The stent was delivered over the neck of the aneurysm, after which the aneurysm was filled with detachable coils through a microcatheter placed into the aneurysm through the stent mesh. Stent delivery and coil embolization was successfully completed in all cases. Complete aneurysm occlusion without coil protrusion or arterial flow compromise was obtained in all patients. A small peripheral subsegmental renal infarction necessitating no therapy was registered in one patient on postembolization computed tomography. At follow-up angiography 1 year after embolization, no aneurysm recanalization or arterial obstruction was registered. Our preliminary experience indicates that stent-assisted coil embolization is technically feasible and effective for the exclusion of challenging renal artery bifurcation aneurysms without the sacrifice of any branch arteries.

Stent-Assisted Gugliemi Detachable Coil Repair of Wide-Necked Renal Artery Aneurysm Using 3-D Angiography

To report a wide-necked renal artery aneurysm treated successfully with stent-assisted Gugliemi detachable coil occlusion, assisted by three-dimensional (3-D) angiography. A 56-year-old woman with history of hypertension presented with a 2.5-cm wide-necked saccular aneurysm involving her distal right renal artery. A balloon-expandable stent was positioned across the neck of the aneurysm and multiple Gugliemi detachable coils were deployed through a microcatheter inserted through the interstices of the stent into the aneurysm sac, guided by 3-D angiography. Follow-up 3-D angiography at 6 months revealed a patent renal artery with continued exclusion of the aneurysm and preservation of renal blood flow. Stent-assisted coil occlusion assisted by 3-D angiography is a potential renal-sparing endovascular approach to treating wide-necked renal artery aneurysms with complex vascular anatomy.