Renal artery aneurysm

Renal artery aneurysms (RAA) are considered the second most common visceral aneurysm (15-22%), most common being splenic artery aneurysm (60%). They are more common in females. Most of the lesions are saccular and tend to occur at the bifurcation of main renal artery.

RAAs occur in ~0.09% of the population 6.

Most cases are asymptomatic. Symptoms usually arise from rupture of aneurysm, embolisation of peripheral vascular bed or arterial thrombosis 1. Hypertension is associated in up to 73% cases of these aneurysm. Haematuria has also been reported in many cases.

Aetiology
CT
  • noncontrast: soft tissue mass lesion in the region or course of renal artery
  • postcontrast: contrast-filled outpouching in the course of the renal artery
Angiography

Aneurysms can be well detected and characterized by angiography, in terms of size, neck diameter and type.

Management depends on various factors like age, sex, severity of hypertension, anticipated pregnancy, and aneurysm morphology. In any young female with anticipated pregnancy, embolization or endovascular intervention is suggested. Pregnancy-associated RAA rupture is associated with 80% mortality.

Follow-up for renal artery aneurysm 5:

  • 1.0-1.5 cm: can be safely followed 6
    • follow-up in 1-2 years, as long as the patient is not premenopausal
  • >1.5 cm
    • consider surgical or endovascular repair
    • surgical treatment is recommended for aneurysms >2 cm in size

Modality of management depends on location:

  • branch RAA: embolisation
  • main renal artery RAA: ligation and bypass surgery, nephrectomy or stent placement
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Article Information

rID: 16267
Tags: refs, aneurysm
Synonyms or Alternate Spellings:
  • Renal artery aneurysms
  • Aneurysm of renal artery
  • Renal arterial aneurysm
  • Renal arterial aneurysms
  • Aneurysmal dilatation of the renal artery
  • Aneurysms of the renal artery

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Cases and Figures

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     Case 3
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    Case 4: thrombosed saccular aneurysm
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    The aneurysm is a...
    Case 5: which has ruptured
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    Case 9: with FMD
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