Renal artery pseudoaneurysm

Case contributed by Dr Luu Hanh

Presentation

Hematuria. History of percutaneous nephrolithotomy 1 month ago.

Patient Data

Age: 60 years
Gender: Male
ct

A pseudoaneurysm measuring 23 x 25 x 33 mm can be seen at the lower pole of the left kidney. It is next to the renal pelvis.

Additional findings: left renal stone, left ureteric stent, blood in the bladder.

dsa

The renal angiography was done and a pseudoaneurysm arising from the left inferior segmental artery was confirmed.

Selective coil embolization was unsuccessful due to the high-velocity flow. The mixture of lipiodol and histoacryl was substituted. Eventually, the affected artery was embolized, and the pseudoaneurysmal sac was involuted.

Case Discussion

CT contrast and renal angiography findings demonstrate a renal artery pseudoaneurysm which occurs most commonly following a renal intervention. Endovascular selective angioembolization is the effective treatment to block flow into pseudoaneurysmal sacs and prevent rupture of the pseudoaneurysm.

Thanks to the interventional radiology team: Trinh Van Thai, Nguyen Ngoc Son, Tran Van Ngoc, Pham Van Long. 

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