A Rare Case of Spontaneous Asymptomatic Renal Artery Pseudoaneurysm Treated with Coil Embolization: A Case Report

Abstract

Background Renal artery pseudoaneurysm (RAP) is a rare renal vascular abnormality but a life-threatening condition that requires multiple imaging modalities for diagnosis and successful management. It can occur as a complication associated with a percutaneous renal biopsy procedure, renal surgery, and trauma. Asymptomatic spontaneous RAP is also a rare entity and not reported in literature. Case Presentation A 28-year-old patient presented to the outpatient department for ultrasound of the breast for mastalgia and routine ultrasound of the abdomen. Ultrasound breast was normal; however, a cystic lesion with color uptake with a yin–yang pattern and to-and-fro spectral waveform was seen in the lower pole of left kidney suggesting a pseudoaneurysm. A computed tomography renal angiogram confirmed the diagnosis. The patient was completely asymptomatic with no history of any renal surgery or intervention or any trauma to the abdomen. Her general and systemic examinations were unremarkable. Digital subtraction angiography and coil embolization of the pseudoaneurysm were performed. Absent of flow in the lesion was demonstrated in postembolization angiography images and ultrasound images. Conclusion RAP has always been described in patients after renal biopsy, surgery, interventions, or trauma. However, we present a case of asymptomatic spontaneous RAP, which was incidentally discovered and effectively treated with coil embolization.

Renal artery pseudoaneurysm after renal biopsy: case report

“…Embolization, with success rates greater than 90%, has emerged as an effective approach for treating RAP. However, considerations for embolization include the potential risk of generalized ischemia due to thrombosis of a major vascular branch and the possibility of permanent renal damage [5,[9][10][11][12][13].…”

Endovascular Embolization of Spontaneously Ruptured Renal Artery Pseudoaneurysm in a Post-Partum Woman: A Case Report

“…Later dissolution of the clot and surrounding necrotic tissue results in recanalization between the intravascular and extravascular space, which ultimately leads to formation of a pseudoaneurysm. With restoration of normal blood flow in the artery, the pseudoaneurysm can grow in size and eventually become unstable, with erosion into the surrounding perinephric tissue [3][4][5].…”

“…Although these lesions can be managed surgically, renal artery embolization is preferred if they are amenable to embolization to minimize the loss of normal renal parenchyma. Spontaneous pseudoaneurysm of segmental renal artery is also a rare entity [2][3][4].…”

Renal artery pseudoaneurysms post percutaneous nephrolithotomy: A case report

“…Angiographic embolization is the treatment of choice for RAP due to its minimally invasive and absence of parenchymal loss [5] .…”