Indications for Surgery on Renal Artery Aneurysms

Abstract

Indications for an operation on renal artery aneurysms include patients 1) with a rupture or an impending rupture, 2) with a possibility of pregnancy, 3) with hypertension and renin differentials suggesting remediable disease and 4) with functional or symptomatic impairment traceable to the aneurysm proper. If the aneurysm is calcified some temporization may be justified, although this observation alone should be only of secondary importance. The size of the aneurysm is likewise generally of secondary value. Of course, the patient's picture and expectancy need balancing in the decision. Conservative management in other situations is acceptable, particularly for the elderly.

Surgery for Renal Artery Aneurysms: A Combined Series of Two Large Centers

“…There are several potential complications of renal artery aneurysms including peripheral dissection, thrombosis, renal infarction and rupture with hemorrhage [11, 13, 14, 16, 17, 18]. Although the incidence of rupture of a renal artery aneurysm is relatively low, the consequences are often devastating with reported mortality rates of 70–80% [6, 10].…”

Rupture of Renal Artery Aneurysm

“…On the contrary, Harrow and Sloan [3] considered that it was not necessary to operate on a calcified aneurysm in asymptomatic normotensive patients. McCarron et al [4] compiled 126 cases of atherosclerotic aneurysm and noted that only 5% of the cases had ruptures. They denied surgical indication on an asymptomatic athero sclerotic aneurysm unless the patient was a female in child-bearing age.…”

Open and endovascular treatment by covered and multilayer stents in the therapy of renal artery aneurysms: mid and long term outcomes in a single center experience

“…In the scientific community considerable controversy continues to surround indication and choice of treatment. Whitsell suggests a conservative approach in the most of cases and open surgery in patients with rupture or upcoming rupture, pregnancy, with or without symptoms related directly to the aneurysm (9). Conversely, Clorius supports the need for aggressive treatment regardless of symptoms or size (10).…”