Natural History and Chronological Growth Rate of Renal Artery Aneurysms

Abstract

Objective: Renal artery aneurysm (RAA) is an uncommon disease, the natural course of which is still not well known. The objective of this study is to define factors that affect the growth rate of RAAs.Materials and Methods: We retrospectively reviewed 32 aneurysms in 26 patients at our institute between January 2010 and March 2016. Basal demographics, comorbidities, reason for diagnosis, and details of the aneurysms and interventions were recorded. The chronological changes in the diameter of the RAA using multiplanar reconstructions of computed tomography images were measured and analyzed.Results: The baseline mean diameter was 20.1±8.4 mm (range: 9.9–41). The mean follow-up period was 3.13±2.1 y (range: 0.5–7.1). The median growth rate was 0.35 mm/y (interquartile range: 0.05, 0.62). The growth rate was slower when the initial diameter was <20 mm than when it was >20 mm (p=0.036). Also, whole-completed calcification was a significant factor for slower growth (p=0.016). We performed ex-vivo surgery in two cases and coil packing with stenting in one. No ruptures occurred during the study period.Conclusion: Our results suggest that cases with an RAA diameter <20 mm do not require intervention. The interval period can be longer in whole-completed calcification types.

Endovascular Treatment of a Giant Renal Artery Aneurysm with High-Flow Renal Arteriovenous Malformation

“…The definition of an RAA is based on the artery’s dilatation twice the diameter of a normal renal artery, and symptomatology includes one or more of the following: flank pain, hematuria, renal emboli, infarction, and renovascular hypertension [ 5 , 6 ]. According to the literature, the rupture of asymptomatic RAAs outside the pregnancy period is extremely rare, and for this reason, the suggested treatment is conservative [ 7 ]. However, these data were based mainly on mid-term follow-up of small RAAs, with a mean diameter of 20 mm, and considering the age of these patients, the operative treatment is indicated in RAAs larger than 25 mm.…”