Successfully treated isolated renal artery pseudoaneurysm in a patient with Behçet's disease

Abstract

Renal artery aneurysms and pseudoaneurysms are an uncommon clinical problem with a low incidence rate. They are abnormal dilatations of the vessel lumen with some different natures. However, the rupture of an aneurysm and pseudoaneurysm is the most dreaded complication because it causes death of the patient. There are many causes of renal artery aneurysm and pseudoaneurysm, including Behçet's disease; however, renal involvement in Behçet's disease is less frequent. We report a case of renal artery pseudoaneurysm induced by Behçet's disease and treated successfully with coil embolization. A 56-year-old woman with Behçet's disease presented with an incidental left renal artery pseudoaneurysm measuring 18 mm. We successfully performed endovascular treatment with coil embolization instead of surgical treatment.

Isolated brachial artery aneurysm successfully treated with a covered stent in a patient with Behçet's disease

“…Endovascular treatment is currently considered an effective and safe procedure with acceptable vascular complication rates. [15] In conclusion, as shown in our case, brachial artery aneurysms which are rarely seen in Behçet's disease patients can be also successfully treated with endovascular repair, thereby, avoiding complications of surgery.…”

Coil embolization of ruptured distal renal artery pseudoaneurysm with gross hematuria and hemorrhagic shock

“… 2 , 3 , 12 Pseudoaneurysms can result from vasculitis caused by Behçet disease and Kawasaki disease. 4 , 5 Pseudoaneurysms of the intraparenchymal vasculature can be caused by amphetamine use. 2 …”

“… 2 Renal artery pseudoaneurysms are caused by iatrogenic or traumatic penetrating injuries, blunt trauma, and inflammatory disease. 3 , 4 , 5 Pseudoaneurysms form when injury to the arterial wall has occurred, resulting in a perfused hematoma in communication with the arterial lumen. 2 Pseudoaneurysms rupture when the hematoma dissolves and the connection between the arterial lumen and extraluminal space is reestablished.…”

“… 6 Treatment is critical, because a ruptured pseudoaneurysm can result in hypovolemic shock and death. 1 , 2 , 4 The use of endovascular interventions, such as coil embolization and covered stents, has resulted in decreased morbidity and mortality compared with open surgical repair. 2 , 7 Treatment should be pursued once a renal artery pseudoaneurysm has been identified.…”

Spontaneous rupture of a renal artery pseudoaneurysm in a hemodialysis patient

“…[ 5 ] Acquired RAPs have been reported as a result of blunt trauma, [ 6 ] penetrating trauma, and urological interventions such as partial nephrectomy, [ 7 ] percutaneous nephrolithotomy, [ 8 ] renal biopsy, [ 9 ] and renal transplantation. [ 10 ] Malignancy, coagulopathy, radiation, cyclophosphamide use, [ 11 ] uncontrolled hypertension, [ 12 ] and systemic vasculitis such as Behcet's disease [ 13 ] have also been reported as contributing factors. In previously reported cases, the longest interval between initial trauma and the diagnosis of aneurysm rupture was 15 years.…”