Advertisement

CardioVascular and Interventional Radiology

, Volume 34, Issue 5, pp 926–935 | Cite as

Endovascular Techniques for the Treatment of Renal Artery Aneurysms

  • Omar Elaassar
  • Julien Auriol
  • Romero Marquez
  • Philippe Tall
  • Hervé Rousseau
  • Francis Joffre
Clinical Investigation

Abstract

Purpose

Our goal was to analyze the indications and limitations of the different percutaneous endovascular approaches reported for the treatment of renal artery aneurysms (RAAs) and to develop a scientific approach for optimum selection of treatment strategy of RAAs through analyzing our experience and reviewing available literature.

Methods

This retrospective study was designed to evaluate the treatment and follow-up of 13 consecutive patients who presented with 13 RAAs by using a variety of endovascular interventional techniques. Different combinations of coil embolization, liquid embolization, stenting, and stent-graft exclusion were used in correlation with variable-specific aneurysm criteria.

Results

All patients were successfully treated with no significant short- or long-term complications. Patients were followed for an average period of 43 (range 13–103) months.

Conclusions

Ten different determinants were found to affect our decision making: shape, size, neck, position of aneurysm on artery, branches arising, artery involved, condition of the artery, age, general condition of the patient, and renal function.

Keywords

Renal artery aneurysms RAAs Percutaneous endovascular techniques Stent Stent-graft exclusion Coil Liquid embolizing agents Onyx 

Notes

Conflict of interest

The authors declare that they have no conflict of interest.

References

  1. 1.
    Tham G, Ekelund L, Herrlin K et al (1983) Renal artery aneurysms. Natural history and prognosis. Ann Surg 197:348–352PubMedCrossRefGoogle Scholar
  2. 2.
    Deterling RA Jr (1971) Aneurysm of the visceral arteries. J Cardiovasc Surg (Torino) 12:309–322Google Scholar
  3. 3.
    Aranzulla TC, Colombo A, Sangiorgi GM (2007) Successful endovascular renal artery aneurysm exclusion using the Venture catheter and covered stent implantation: a case report and review of the literature. J Invasive Cardiol 19:246–253Google Scholar
  4. 4.
    Abath C, Andrade G, Cavalcanti D et al (2007) Complex renal artery aneurysms: liquids or coils? Tech Vasc Interv Radiol 10:299–307PubMedCrossRefGoogle Scholar
  5. 5.
    Rautio R, Haapanen A (2007) Transcatheter embolization of a renal artery aneurysm using ethylene vinyl alcohol copolymer. Cardiovasc Interv Radiol 30:300–303CrossRefGoogle Scholar
  6. 6.
    Nosher JL, Chung J, Brevetti LS et al (2006) Visceral and renal artery aneurysms: a pictorial essay on endovascular therapy. Radiographics 26:1687–1704PubMedCrossRefGoogle Scholar
  7. 7.
    Henke PK, Cardneau JD, Welling TH 3rd et al (2001) Renal artery aneurysms: a 35-year clinical experience with 252 aneurysms in 168 patients. Ann Surg 234:454–462PubMedCrossRefGoogle Scholar
  8. 8.
    Pfeiffer T, Reiher L, Grabitz K et al (2003) Reconstruction for renal artery aneurysm: operative techniques and long-term results. J Vasc Surg 37:293–300PubMedCrossRefGoogle Scholar
  9. 9.
    Pershad A, Heuser R (2004) Renal artery aneurysm: successful exclusion with a stent graft. Catheter Cardiovasc Interv 61:314–316PubMedCrossRefGoogle Scholar
  10. 10.
    Lacombe M (1995) Aneurysms of the renal artery. J Mal Vasc 20:257–263PubMedGoogle Scholar
  11. 11.
    Jeanmonod R, Lewis C (2008) Bilateral renal artery aneurysm rupture in a man with leukemia: report of a case. J Vasc Surg 47:871–873PubMedCrossRefGoogle Scholar
  12. 12.
    Rundback JH, Rizvi A, Rozenblit GN et al (2000) Percutaneous stent-graft management of renal artery aneurysms. J Vasc Interv Radiol 11:1189–1193PubMedCrossRefGoogle Scholar
  13. 13.
    Andersen PE, Rohr N (2005) Endovascular exclusion of renal artery aneurysm. Cardiovasc Interv Radiol 28:665–667CrossRefGoogle Scholar
  14. 14.
    Bastounis E, Pikoulis E, Georgopoulos S et al (1998) Surgery for renal artery aneurysms: a combined series of two large centers. Eur Urol 33:22–27PubMedCrossRefGoogle Scholar
  15. 15.
    Tan WA, Chough S, Saito J et al (2001) Covered stent for renal artery aneurysm. Catheter Cardiovasc Interv 52:106–109PubMedCrossRefGoogle Scholar
  16. 16.
    Hayakawa M, Murayama Y, Duckwiler GR et al (2000) Natural history of the neck remnant of a cerebral aneurysm treated with the Guglielmi detachable coil system. J Neurosurg 93:561–568PubMedCrossRefGoogle Scholar
  17. 17.
    Bonneville F, Sourour N, Biondi A (2006) Intracranial aneurysms: an overview. Neuroimaging Clin N Am 16:371–382PubMedCrossRefGoogle Scholar
  18. 18.
    Klein GE, Szolar DH, Breinl E, Raith J, Schreyer HH (1997) Endovascular treatment of renal artery aneurysms with conventional non-detachable microcoils and Guglielmi detachable coils. Br J Urol 79:852–860PubMedCrossRefGoogle Scholar
  19. 19.
    Damascelli B, Bartorelli AL, Ticha V et al (2008) Large renal artery aneurysm treated with Guglielmi detachable coils: procedural and 4-year follow-up results. Cardiovasc Interv Radiol 31(Suppl 2):S88–S91CrossRefGoogle Scholar
  20. 20.
    Soga Y, Sakai K, Nobuyoshi M (2007) Renal artery aneurysm treatment with coil embolization. Catheter Cardiovasc Interv 69:697–700PubMedCrossRefGoogle Scholar
  21. 21.
    Centenera LV, Hirsch JA, Choi IS et al (1998) Wide-necked saccular renal artery aneurysm: endovascular embolization with the Guglielmi detachable coil and temporary balloon occlusion of the aneurysm neck. J Vasc Interv Radiol 9:513–516PubMedCrossRefGoogle Scholar
  22. 22.
    Lupattelli T, Abubacker Z, Morgan R et al (2003) Embolization of a renal artery aneurysm using ethylene vinyl alcohol copolymer (Onyx). J Endovasc Ther 10:366–370PubMedCrossRefGoogle Scholar
  23. 23.
    Mawad ME, Cekirge S, Ciceri E, Saatci I (2002) Endovascular treatment of giant and large intracranial aneurysms by using a combination of stent placement and liquid polymer injection. J Neurosurg 96:474–482PubMedCrossRefGoogle Scholar
  24. 24.
    Clark TW, Sankin A, Becske T et al (2008) Stent-assisted Gugliemi detachable coil repair of wide-necked renal artery aneurysm using 3-D angiography. Vasc Endovasc Surg 41:528–532CrossRefGoogle Scholar
  25. 25.
    Manninen HI, Berg M, Vanninen RL (2008) Stent-assisted coil embolization of wide-necked renal artery bifurcation aneurysms. J Vasc Interv Radiol 19:487–492PubMedCrossRefGoogle Scholar
  26. 26.
    Gao BL, Li MH, Wang YL et al (2006) Delayed coil migration from a small wide-necked aneurysm after stent-assisted embolization: case report and literature review. Neuroradiology 48:333–337PubMedCrossRefGoogle Scholar
  27. 27.
    Bui BT, Oliva VL, Leclerc G et al (1995) Renal artery aneurysm: treatment with percutaneous placement of a stent-graft. Radiology 195:181–182PubMedGoogle Scholar
  28. 28.
    Rikimaru H, Sato A, Hashizume E et al (2001) Saccular renal artery aneurysm treated with an autologous vein-covered stent. J Vasc Surg 34:169–171PubMedCrossRefGoogle Scholar
  29. 29.
    Liguori G, Trombetta C, Bucci S et al (2002) Percutaneous management of renal artery aneurysm with a stent-graft. J Urol 167:2518–2519PubMedCrossRefGoogle Scholar
  30. 30.
    Mounayer C, Aymard A, Saint-Maurice JP et al (2000) Balloon-assisted coil embolization for large-necked renal artery aneurysms. Cardiovasc Interv Radiol 23:228–230CrossRefGoogle Scholar
  31. 31.
    Dib M, Sedat J, Raffaelli C et al (2003) Endovascular treatment of a wide-neck renal artery bifurcation aneurysm. J Vasc Interv Radiol 14:1461–1464PubMedCrossRefGoogle Scholar
  32. 32.
    Henry M, Polydorou A, Frid N et al (2008) Treatment of renal artery aneurysm with the multilayer stent. J Endovasc Ther 15:231–236PubMedCrossRefGoogle Scholar
  33. 33.
    Mazer MJ, Baltaxe HA, Wolf GL (1981) Therapeutic embolization of the renal artery with Gianturco coils: limitations and technical pitfalls. Radiology 138:37–46PubMedGoogle Scholar
  34. 34.
    Yamakado K, Nakatsuka A, Tanaka N et al (2000) Transcatheter arterial embolization of ruptured pseudoaneurysms with coils and n-butyl cyanoacrylate. J Vasc Interv Radiol 11:66–72PubMedCrossRefGoogle Scholar
  35. 35.
    Park SI, Lee DY, Won JY et al (2000) Renal artery embolization using a new liquid embolic material obtained by partial hydrolysis of polyvinyl acetate (Embol): initial experience in six patients. Korean J Radiol 1:121–126PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC and the Cardiovascular and Interventional Radiological Society of Europe (CIRSE) 2011

Authors and Affiliations

  • Omar Elaassar
    • 1
  • Julien Auriol
    • 1
  • Romero Marquez
    • 2
  • Philippe Tall
    • 2
  • Hervé Rousseau
    • 1
  • Francis Joffre
    • 1
  1. 1.Department of RadiologyRangueil University HospitalToulouseFrance
  2. 2.Angiorad Interventional RadiologyIMIP Medical CenterBoa Vista - Recife-PEBrazil

Personalised recommendations