Natural history and management of renal artery aneurysms in a single tertiary referral center

Brownstein, Adam J.; Erben, Young; Rajaee, Sareh; Li, Yupeng; Rizzo, John A.; Mojibian, Hamid; Ziganshin, Bulat A.; Elefteriades, John A.

doi:10.1016/j.jvs.2017.10.086

Cited by 26 publications

(16 citation statements)

References 22 publications

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“…Whatever the mechanism, hypertension is present in around 70% of patients presenting with a RAA. 19 Consistent with data from the literature, most RAAs from this cohort were right sided and most patients were women. 19…”

Section: Indications For Treatmentsupporting

confidence: 90%

Direct Distal Renal Artery Aneurysm Repair

Jayet

Davaine

Tresson

et al. 2020

European Journal of Vascular and Endovascular Surgery

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WHAT THIS PAPER ADDSIn the era of endovascular techniques, open surgery for distal renal artery aneurysms remains a valuable option when performed in experienced reference centres. This study describes in detail the operative technique used for repair of 24 renal artery aneurysms with direct reconstruction, over a period of three years. Follow up, including patency rate, assessment of arterial pressure as well as renal function monitoring based on serum creatinine levels, is reported.Objective: Treatment of renal artery aneurysms (RAA) remains controversial. Endovascular treatment has increased for main trunk and for very distal aneurysms, whereas for lesions located at the bifurcation surgical treatment seems to be a valid option. The goal of this study was to describe the technique of direct reconstruction of RAA and to report on outcomes. Methods: This study comprised single centre prospective collection of data with retrospective analysis (January 2015 to August 2018) of patients operated on for distal RAA using direct reconstruction. Results: A total of 24 RAA in 21 patients (seven men and 14 women, mean age 59 AE 13 years) was included. History of hypertension was found in 15 patients and renal insufficiency was present in one. Mean preoperative systolic and diastolic blood pressures were 134 AE 21 mmHg and 74 AE 10 mmHg, and mean preoperative rates of creatinine and glomerular filtration rate were 67 AE 13 mmol/L and 93 AE 49 mL/min/ 1.73 m 2 , respectively. Indications for repair were a diameter >20 mm in seven cases (mean diameter ¼ 25 AE 2 mm) or rapid growth in one case, symptomatic aneurysm in 12 cases (hypertension, haematuria, pain), and a concomitant lesion in four cases (splenic aneurysm, abdominal aortic aneurysm, occlusive visceral artery lesions). All lesions were distal, main artery bifurcation in 22 cases and hilar in two cases. The main aetiology was fibromuscular dysplasia (16 cases) followed by atherosclerosis (seven cases) and one case of Ehlers Danlos Syndrome. In situ reconstruction was possible for 22 RAA, while two cases required kidney autotransplantation. The mean renal ischaemia time was 18 AE 5 min. At two years, the patency rate was 100%, and mean systolic blood pressure decreased (134 mmHge122 mmHg, p ¼ .047). Renal function was stable from 93 AE 49 pre-operatively to 95 AE 35 mL/min/1.73 m 2 in the post-operative course (p ¼ .56). Conclusion: Direct reconstruction appears to be efficient for most RAA. This technique is complementary to ex vivo autotransplantation and endovascular treatment.

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Section: Indications For Treatmentsupporting

confidence: 90%

Direct Distal Renal Artery Aneurysm Repair

Jayet

Davaine

Tresson

et al. 2020

European Journal of Vascular and Endovascular Surgery

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“…Autopsy studies report an incidence of about 0.01% to 0.09% of renal artery aneurysms (RAAs) [15,16]. However, recent imaging studies state the incidence of RAA to be almost 1% [17]. The classification can be based on their etiology, anatomic location, or morphology.…”

Section: Renal Artery Aneurysmsmentioning

confidence: 99%

Endovascular Interventional Radiology of the Urogenital Tract

Mucelli

Marrocchio

et al. 2021

Medicina

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Interventional radiology of the male urogenital system includes percutaneous and endovascular procedures, and these last consist mostly of transcatheter arterial embolizations. At the kidney level, arterial embolizations are performed mainly for palliative treatment of parenchymal tumors, for renal traumas and, less frequently, for arteriovenous fistulas and renal aneurysms and pseudoaneurysms. These latter may often require emergency intervention as they can cause renal or peri-renal hematomas or significant hematuria. Transcatheter arterial embolization is also an effective therapy for intractable severe bladder hematuria secondary to a number of neoplastic and inflammatory conditions in the pelvis, including unresectable bladder cancer and radiation-induced or cyclophosphamide-induced hemorrhagic cystitis. Endovascular interventional procedures for the penis are indicated for the treatment of post-traumatic priapism. In this article, we review the main endovascular radiological interventions of the male urogenital system, describing the technical aspects, results, and complications of each procedure at the various anatomical districts.

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“…Because the dependent variable has been transformed to the natural log form, we use Duan's smearing estimator to calculate the expected value of the untransformed dependent variable. 18 This regression method of assessment of growth rate minimizes measurement error and prevents overweighing data of patients with stable aneurysms by using only two imaging scans per patient.…”

Section: Definition Of Aneurysm Of the Aabvsmentioning

confidence: 99%