Abstract
A renal artery aneurysm is defined as a dilated segment of renal artery that exceeds twice the diameter of a normal renal artery. Although rare, the diagnosis and incidence of this entity have been steadily increasing due to the routine use of cross-sectional imaging. In certain cases, renal artery aneurysms may be clinically important and potentially lethal. However, knowledge of their occurrence, their natural history, and their prognosis with or without treatment is still limited. This article aims to review the recent literature concerning renal artery aneurysms, with special consideration given to physiopathology, indications for treatment, different technical options, post-procedure complications and treatment outcomes.
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Abbreviations
- RAAs:
-
Renal artery aneurysms
- CT:
-
computerized tomography
- MRA:
-
magnetic resonance angiography
- DSA:
-
digital subtraction arteriography
- EV:
-
endovascular therapy
- OR:
-
open repair
- C:
-
conservative management
- RALR:
-
robotic-assisted laparoscopic repair
- RI:
-
renal infarct
- PES:
-
post-embolization syndrome
- Thr:
-
thrombosis
- Stn:
-
stenosis
References
Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of outstanding importance
Tham G, Ekelund L, Herrlin K, et al. Renal artery aneurysms. Natural history and prognosis. Ann Surg. 1983;197:348–52.
Bulbul MA, Farrow GA. Renal artery aneurysms. Urology. 1992;40(2):124–6.
Cerny JC, Chang C, Fry WJ. Renal artery aneurysms. Arch Surg. 1968;96:653–63.
Stanley JC, Rhodes EL, Gewertz BL, Chang CY, Walter JF, Fry WJ. Renal artery aneurysms. Significance of macroaneurysms exclusive of dissections and fibrodysplastic mural dilatations. Arch Surg. 1975;110:1327–33.
Rouppe DL. Nova Acta Phys-Med Acad Nat Curios. 1770;iv:76.
Bussutil RW, Brin BJ. The diagnosis and management of visceral artery aneurysms. Surgery. 1980;88:619–30.
Abeshouse BS. Aneurysm of renal artery: report of 2 cases and review of literature. Urol Cutan Rev. 1951;55:451–63.
Edsman G. Angionephrography and suprarenal angiography. A roentgenologic study of the normal kidney. Expansive renal and suprarenal lesions and renal aneurysms. Acta Radiol. 1957;155:104–16.
DeBakey ME, Lefrak EA, Garcia-Rinaldi R, Noon GP. Aneurysm of the renal artery. Arch Surg. 1973;106:438–43.
Hageman JH, Smith RF, Szilagyi DM, Elliott JP. Aneurysms of the renal artery: problems of prognosis and surgical management. Surgery. 1978;84:563–72.
Henriksson C, Lukes P, Nilson AE, Pettersson S. Angiographically discovered, non-operated renal artery aneurysms. Scand J Urol Nephrol. 1984;18:59–62.
Hubert Jr JP, Pairolero PC, Kazmier FJ. Solitary renal artery aneurysm. Surgery. 1980;88:557–65.
Dzsinich C, Gloviczki P, McKusick MA, et al. Surgical management of renal artery aneurysm. Cardiovasc Surg. 1993;1:243–7.
Lawrie GM, Morris Jr GC, Glaeser DH, Debakey ME. Renovascular reconstruction: factors affecting long-term prognosis in 919 patients up to 31 years. Am J Cardiol. 1989;63:1085–92. Classical, large series of RAAs.
Henke PK, Cardneau JD, Welling III TH, et al. Renal artery aneurysms: a 35-year clinical experience with 252 aneurysms in 168 patients. Ann Surg. 2001;234:454–62. discussion 462–463. Classical, large series of RAAs.
Faggiolo GL, Gargiulo M, Bertoni F, Tarantini S, Stella A. Hypertension due to an aneurysm of the left renal artery in a patient with neurofibromatosis. Ann Vasc Surg. 1992;6:456–9.
Sharma AK. Renal artery aneurysm, hypertension and neurofibromatosis. J R Soc Med. 1991;84:373–4.
Nosher JL, Chung J, Brevetti LS, Graham AM, Siegel RL. Visceral and renal artery aneurysms: a pictorial essay on endovascular therapy. Radiographics. 2006;26:1687–704. quiz 1687.
Salam TA, Lumsden AB, Martin LG, Smith 3rd RB. Nonoperative management of visceral aneurysms and pseudoaneurysms. Am J Surg. 1992;164:215–9.
Smith DL, Wernick R. Spontaneous rupture of a renal artery aneurysm in polyarteritis nodosa. Critical review of the literature and report of a case. Am J Med. 1989;87:464–7.
Rundback JH, Rizvi A, Rozenblit GN, et al. Percutaneous stent-graft management of renal artery aneurysms. J Vasc Interv Radiol. 2000;11:1189–93. Updated classification of RAAs with management implications.
Ribroek A, Van Dick HA, Roex AJM. Rupture of renal artery aneurysm during pregnancy. Eur J Vasc Surg. 1994;8:375–6.
Calligaro KD, Dougherty MJ. Renal artery aneurysms and arteriovenous fistulae. In: Rutherford RB, editor. Vascular surgery. 5th ed. Philadelphia: WB Saunders; 2000. p. 1697–702.
Youkey JR, Collins Jr GJ, Orecchia PM, et al. Saccular renal artery aneurysm as a cause of hypertension. Surgery. 1985;97:498–501.
Nordhus O, Ekestrom S, Liljeqvist L. Surgical treatment of renal artery aneurysms. Scand J Thorac Cardiovasc Surg. 1977;11:243–9.
Cummings KB, Lecky JW, Kaufman JJ. Renal artery aneurysms and hypertension. J Urol. 1973;109:144–8.
Hidai H, Kinoshita Y, Murayama T, et al. Rupture of renal artery aneurysm. Eur Urol. 1985;11:249–53.
Ippolito JJ, Le Veen HH. Treatment of renal artery aneurysms. J Urol. 1960;83:10–6.
Martin III RS, Meacham PW, Dietesheim GA, Mulherin Jr JL, Edwards WH. Renal artery aneurysms: selective treatment for hypertension and prevention of rupture. J Vasc Surg. 1989;9:26–34.
Patterson WM. Maternal death due to undiagnosed left renal artery aneurysm associated with an absent right kidney. Proc Roy Soc Med 1973; 66:761–62. 9. Saleh YZ, McLeod FN. Ruptured renal artery aneurysm in pregnancy. Br J Obstet Gynecol 1977; 84:391–93.
Cohen JR, Shamash FS. Ruptured renal artery aneurysms during pregnancy. J Vasc Surg. 1987;6:51–9.
Dayton B, Helgerson RB, Sollinger HW, Acher CW. Ruptured renal artery aneurysm in a pregnant uninephric patient: successful ex vivo repair and autotransplantation. Surgery. 1990;107:708–11.
Whiteley MS, Katoch R, Kennedy RH, Bidgood KA, Baird RN. Ruptured renal artery aneurysm in the first trimester of pregnancy. Eur J Vasc Surg. 1994;8:238–9.
Lumsden AB, Salam TA, Walton KG. Renal artery aneurysm: a report of 28 cases. Cardiovasc Surg. 1996;4:185–9.
Poutasse EF. Renal artery aneurysms. J Urol. 1975;113:443–9.
Hupp T, Allenberg JR, Post K, Roeren T, Meier M, Clorius JH. Renal artery aneurysm: surgical indication and results. Eur J Vasc Surg. 1992;6:477–86.
Chadha M, Ahuja C. Visceral artery aneurysms: diagnosis and percutaneous management. Sem Interv Radiol. 2009;26:196–206. Controversial issues in RAAs diagnosis.
Chimpiri AR, Natarajan B. Renal vascular lesions: diagnosis and endovascular management. Sem Interv Radiol. 2009;26:253–61. Controversial issues in RAAs diagnosis.
Bastounis E, Pikoulis E, Georgopoulos S, et al. Surgery for renal artery aneurysms: a combined series of two large centers. Eur Urol. 1998;33:22–7.
Pfeiffer T, Reiher L, Grabitz, et al. Reconstruction for renal artery aneurysms: operative techniques and long-term results. J Vasc Surg. 2003;37:293–300.
Ansari WA, Al-Fares SA, Alzobydi A, Al-Qarni A, Ansari MAAW, Fatima S. Ruptured renal artery aneurysm in a young female, a clinical dilemma. Bombay Hosp J. 2009;51:112–4.
English WP, Pearce JD, Craven TE, et al. Surgical management of renal artery aneurysms. J Vasc Surg. 2004;40:53–60.
Sorcini A, Libertino JA. Vascular reconstruction in urology. Urol Clin N Am. 1999;26:219–34. x-xi.
Zhang Z, Yang M, Song L, Tong X, Zou Y. Endovascular treatment of renal artery aneurysms and renal arteriovenous fistulas. J Vasc Surg. 2013;57:765–70. Endovascular management of RAAs current series.
Abdel-Kerim A, Cassagnes L, Alfidja A, Gageanu C, Favrolt G, Dumousset E, et al. Endovascular treatment of eight renal artery aneurysms. Acta Radiol. 2012;53:430–4. Endovascular management of RAAs current series.
Balderi A, Antonietti A, Ferro L, Peano E, Pedrazzini F, Fonio P, et al. Endovascular treatment of visceral artery aneurysms and pseudoaneurysms: our experience. Radiol Med. 2012;117:815–30. Endovascular management of RAAs current series.
Sildiroglu O, Saad WE, Hagspiel KD, Matsumoto AH, Turba UC. Endovascular management of iatrogenic native renal arterial pseudoaneurysms. Cardiovasc Intervent Radiol. 2012;35:1340–5. Endovascular management of RAAs current series.
Etezadi V, Gandhi RT, Benenati JF, Rochon P, Gordon M, Benenati MJ, et al. Endovascular treatment of visceral and renal artery aneurysms. J Vasc Interv Radiol. 2011;22:1246–53. Endovascular management of RAAs current series.
Cochennec F, Riga CV, Allaire E, Cheshire NJ, Hamady M, Jenkins MP, et al. Contemporary management of splanchnic and renal artery aneurysms: results of endovascular compared with open surgery from two European vascular centers. Eur J Vasc Endovasc Surg. 2011;42:340–6. Recent large series of RAAs: surgical and endovascular management.
Marone EM, Mascia D, Kahlberg A, Brioschi C, Tshomba Y, Chiesa R. Is open repair still the gold standard in visceral artery aneurysm management? Ann Vasc Surg. 2011;25:936–46. Recent large series of RAAs: surgical and endovascular management.
Belzer FO, Salvatierra O, Palubinskas A, Stoney RJ. Ex vivo renal artery reconstruction. Ann Surg. 1975;182:456–62.
Shirodkar SP, González J, Parodi J, Omaida V, Bird V, Burke GW, et al. Open or laparoscopic nephrectomy and extracoroporeal repair of complicated renal artery aneurysms: techniques for renal salvage. Arch Esp Urol. 2011;64:227–36. Recent series of ex vivo repair and autotransplantation for complex RAAs.
Robinson 3rd W, Bafford R, Belkin M, Menard MT. Favorable outcomes with in situ techniques for surgical repair of complex renal artery aneurysms. J Vasc Surg. 2011;53:684–91. Recent large series of RAAs surgical management.
Giulianotti PC, Bianco FM, Addeo P, Lombardi A, Coratti A, Sbrana F. Robot-assisted laparoscopic repair of renal artery aneurysms. J Vasc Surg. 2010;51:842–9. Current series of robotic-assisted, laparoscopic surgical management for RAAs.
Chandra A, O'Connell JB, Quinones-Baldrich WJ, Lawrence PF, Moore WS, Gelabert HA, et al. Aneurysmectomy with arterial reconstruction of renal artery aneurysms in the endovascular era: a safe, effective treatment for both aneurysm and associated hypertension. Ann Vasc Surg. 2010;24:503–10. Recent series of RAAs surgical management.
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Dr. Javier González, Dr. Manuel Esteban, Dr. Guillermo Andrés, Dr. Estefania Linares, and Dr. Juan Ignacio Martínez-Salamanca declare that there are no conflicts of interest relevant to this article.
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González, J., Esteban, M., Andrés, G. et al. Renal Artery Aneurysms. Curr Urol Rep 15, 376 (2014). https://doi.org/10.1007/s11934-013-0376-z
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DOI: https://doi.org/10.1007/s11934-013-0376-z