Renal artery pseudoaneurysm

Abstract

The renal artery pseudoaneurysm embody a rare vascular complication coming of percutaneous procedures, renal biopsy, nephrectomy, penetrating traumas and more rarely blunt traumas. The clinical can be vary according the patient, the haematuria is the symptom more commom. Is necessary a high level of clinical suspicion for your diagnosis, this can be elucidated by through complementary exams as the eco-color Doppler and the computed tomography scan (CT). This report is a case of a patient submitted a right percutaneous renal biopsy and that, after the procedure started with macroscopic haematuria, urinary tenesmus and hypogastric pain. The diagnosis of pseudoaneurysm was given after one week of evolution when the patient was hospitalized because gross haematuria, tachycardia, hypotension and hypochondrium pain. In the angiotomography revealed a focal dilation of the accessory right renal inferior polar artery, dilation of renal pelvis and all the ureteral course with presence hyperdenso material (clots) inside the middle third of the ureter. The treatment for the majority of this cases are conservative, through arterial embolization, indicated for thouse of smaller dimensions in patients who are hemodynamically stable. However, it was decided by clinical treatment with aminocaproic acid 1 g, according to previous studies for therapy of haematuria. The patient received discharge without evidence of macroscopic haematuria and with normal renal ultrasound, following ambulatory care.

Free‐breathing three‐dimensional isotropic‐resolution MR sequence for simultaneous vessel wall imaging of bilateral renal arteries and abdominal aorta: Feasibility and reproducibility

“…Third, the proposed iMSDE‐SPGR sequence may be applied to the follow‐up investigation due to its excellent scan–rescan reproducibility (Table 3). Percutaneous procedures, renal biopsy, and nephrectomy may cause renal artery pseudoaneurysm 39,40 . The characteristics of the renal arteries such as stiffness and wall thickness are confirmed to be changed during the procedure of chronic renal failure and after kidney transplant, hemodialysis, and renal denervation 19,41,42 .…”

Case – Renal artery pseudoaneurysm: A life-threatening occurrence following thulium laser lithotripsy

“…Renal artery pseudoaneurysms can be managed by either open surgical or endovascular access, depending on the stability of the patient 10 . Endovascular selective angioembolization is the mainstay of treatment, although open surgical correction might be indicated if unable to obtain haemostasis endovascular techniques or repair of the arterial wall defect are required 11 .…”

Endovascular treatment of a giant renal artery aneurysm

“…Renal artery aneurysms (RAA) are a rare phenomenon. Historically, the incidence of RAA has been estimated at 0.1%, 1 although CT and Angiographic based studies have found rates between 0.3% and 2.5% 2 . Over two‐thirds of patients with RAA are female, and 68% of female cases are associated with fibromuscular dysplasia 2 .…”

“…5 Most RAAs have a saccular morphology, with 10-20% occurring bilaterally. 1 RAAs typically display slow growth rates of 0.06-0.6 mm/year. 2 Most patients are asymptomatic but may present with abdominal or flank pain with associated haematuria.…”