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Renal Artery Aneurysms

  • Kidney Diseases (G Ciancio, Section Editor)
  • Published:
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Abstract

A renal artery aneurysm is defined as a dilated segment of renal artery that exceeds twice the diameter of a normal renal artery. Although rare, the diagnosis and incidence of this entity have been steadily increasing due to the routine use of cross-sectional imaging. In certain cases, renal artery aneurysms may be clinically important and potentially lethal. However, knowledge of their occurrence, their natural history, and their prognosis with or without treatment is still limited. This article aims to review the recent literature concerning renal artery aneurysms, with special consideration given to physiopathology, indications for treatment, different technical options, post-procedure complications and treatment outcomes.

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Abbreviations

RAAs:

Renal artery aneurysms

CT:

computerized tomography

MRA:

magnetic resonance angiography

DSA:

digital subtraction arteriography

EV:

endovascular therapy

OR:

open repair

C:

conservative management

RALR:

robotic-assisted laparoscopic repair

RI:

renal infarct

PES:

post-embolization syndrome

Thr:

thrombosis

Stn:

stenosis

References

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of outstanding importance

  1. Tham G, Ekelund L, Herrlin K, et al. Renal artery aneurysms. Natural history and prognosis. Ann Surg. 1983;197:348–52.

    Article  CAS  PubMed  Google Scholar 

  2. Bulbul MA, Farrow GA. Renal artery aneurysms. Urology. 1992;40(2):124–6.

    Article  CAS  PubMed  Google Scholar 

  3. Cerny JC, Chang C, Fry WJ. Renal artery aneurysms. Arch Surg. 1968;96:653–63.

    Article  CAS  PubMed  Google Scholar 

  4. Stanley JC, Rhodes EL, Gewertz BL, Chang CY, Walter JF, Fry WJ. Renal artery aneurysms. Significance of macroaneurysms exclusive of dissections and fibrodysplastic mural dilatations. Arch Surg. 1975;110:1327–33.

    Article  CAS  PubMed  Google Scholar 

  5. Rouppe DL. Nova Acta Phys-Med Acad Nat Curios. 1770;iv:76.

    Google Scholar 

  6. Bussutil RW, Brin BJ. The diagnosis and management of visceral artery aneurysms. Surgery. 1980;88:619–30.

    Google Scholar 

  7. Abeshouse BS. Aneurysm of renal artery: report of 2 cases and review of literature. Urol Cutan Rev. 1951;55:451–63.

    CAS  PubMed  Google Scholar 

  8. Edsman G. Angionephrography and suprarenal angiography. A roentgenologic study of the normal kidney. Expansive renal and suprarenal lesions and renal aneurysms. Acta Radiol. 1957;155:104–16.

    Google Scholar 

  9. DeBakey ME, Lefrak EA, Garcia-Rinaldi R, Noon GP. Aneurysm of the renal artery. Arch Surg. 1973;106:438–43.

    Article  CAS  Google Scholar 

  10. Hageman JH, Smith RF, Szilagyi DM, Elliott JP. Aneurysms of the renal artery: problems of prognosis and surgical management. Surgery. 1978;84:563–72.

    CAS  PubMed  Google Scholar 

  11. Henriksson C, Lukes P, Nilson AE, Pettersson S. Angiographically discovered, non-operated renal artery aneurysms. Scand J Urol Nephrol. 1984;18:59–62.

    Article  CAS  PubMed  Google Scholar 

  12. Hubert Jr JP, Pairolero PC, Kazmier FJ. Solitary renal artery aneurysm. Surgery. 1980;88:557–65.

    PubMed  Google Scholar 

  13. Dzsinich C, Gloviczki P, McKusick MA, et al. Surgical management of renal artery aneurysm. Cardiovasc Surg. 1993;1:243–7.

    CAS  PubMed  Google Scholar 

  14. Lawrie GM, Morris Jr GC, Glaeser DH, Debakey ME. Renovascular reconstruction: factors affecting long-term prognosis in 919 patients up to 31 years. Am J Cardiol. 1989;63:1085–92. Classical, large series of RAAs.

    Article  CAS  PubMed  Google Scholar 

  15. Henke PK, Cardneau JD, Welling III TH, et al. Renal artery aneurysms: a 35-year clinical experience with 252 aneurysms in 168 patients. Ann Surg. 2001;234:454–62. discussion 462–463. Classical, large series of RAAs.

    Article  CAS  PubMed  Google Scholar 

  16. Faggiolo GL, Gargiulo M, Bertoni F, Tarantini S, Stella A. Hypertension due to an aneurysm of the left renal artery in a patient with neurofibromatosis. Ann Vasc Surg. 1992;6:456–9.

    Article  Google Scholar 

  17. Sharma AK. Renal artery aneurysm, hypertension and neurofibromatosis. J R Soc Med. 1991;84:373–4.

    CAS  PubMed Central  PubMed  Google Scholar 

  18. Nosher JL, Chung J, Brevetti LS, Graham AM, Siegel RL. Visceral and renal artery aneurysms: a pictorial essay on endovascular therapy. Radiographics. 2006;26:1687–704. quiz 1687.

    Article  PubMed  Google Scholar 

  19. Salam TA, Lumsden AB, Martin LG, Smith 3rd RB. Nonoperative management of visceral aneurysms and pseudoaneurysms. Am J Surg. 1992;164:215–9.

    Article  CAS  PubMed  Google Scholar 

  20. Smith DL, Wernick R. Spontaneous rupture of a renal artery aneurysm in polyarteritis nodosa. Critical review of the literature and report of a case. Am J Med. 1989;87:464–7.

    Article  CAS  PubMed  Google Scholar 

  21. Rundback JH, Rizvi A, Rozenblit GN, et al. Percutaneous stent-graft management of renal artery aneurysms. J Vasc Interv Radiol. 2000;11:1189–93. Updated classification of RAAs with management implications.

    Article  CAS  PubMed  Google Scholar 

  22. Ribroek A, Van Dick HA, Roex AJM. Rupture of renal artery aneurysm during pregnancy. Eur J Vasc Surg. 1994;8:375–6.

    Article  Google Scholar 

  23. Calligaro KD, Dougherty MJ. Renal artery aneurysms and arteriovenous fistulae. In: Rutherford RB, editor. Vascular surgery. 5th ed. Philadelphia: WB Saunders; 2000. p. 1697–702.

    Google Scholar 

  24. Youkey JR, Collins Jr GJ, Orecchia PM, et al. Saccular renal artery aneurysm as a cause of hypertension. Surgery. 1985;97:498–501.

    CAS  PubMed  Google Scholar 

  25. Nordhus O, Ekestrom S, Liljeqvist L. Surgical treatment of renal artery aneurysms. Scand J Thorac Cardiovasc Surg. 1977;11:243–9.

    CAS  PubMed  Google Scholar 

  26. Cummings KB, Lecky JW, Kaufman JJ. Renal artery aneurysms and hypertension. J Urol. 1973;109:144–8.

    CAS  PubMed  Google Scholar 

  27. Hidai H, Kinoshita Y, Murayama T, et al. Rupture of renal artery aneurysm. Eur Urol. 1985;11:249–53.

    CAS  PubMed  Google Scholar 

  28. Ippolito JJ, Le Veen HH. Treatment of renal artery aneurysms. J Urol. 1960;83:10–6.

    CAS  PubMed  Google Scholar 

  29. Martin III RS, Meacham PW, Dietesheim GA, Mulherin Jr JL, Edwards WH. Renal artery aneurysms: selective treatment for hypertension and prevention of rupture. J Vasc Surg. 1989;9:26–34.

    PubMed  Google Scholar 

  30. Patterson WM. Maternal death due to undiagnosed left renal artery aneurysm associated with an absent right kidney. Proc Roy Soc Med 1973; 66:761–62. 9. Saleh YZ, McLeod FN. Ruptured renal artery aneurysm in pregnancy. Br J Obstet Gynecol 1977; 84:391–93.

    Google Scholar 

  31. Cohen JR, Shamash FS. Ruptured renal artery aneurysms during pregnancy. J Vasc Surg. 1987;6:51–9.

    Article  CAS  PubMed  Google Scholar 

  32. Dayton B, Helgerson RB, Sollinger HW, Acher CW. Ruptured renal artery aneurysm in a pregnant uninephric patient: successful ex vivo repair and autotransplantation. Surgery. 1990;107:708–11.

    CAS  PubMed  Google Scholar 

  33. Whiteley MS, Katoch R, Kennedy RH, Bidgood KA, Baird RN. Ruptured renal artery aneurysm in the first trimester of pregnancy. Eur J Vasc Surg. 1994;8:238–9.

    Article  CAS  PubMed  Google Scholar 

  34. Lumsden AB, Salam TA, Walton KG. Renal artery aneurysm: a report of 28 cases. Cardiovasc Surg. 1996;4:185–9.

    Article  CAS  PubMed  Google Scholar 

  35. Poutasse EF. Renal artery aneurysms. J Urol. 1975;113:443–9.

    CAS  PubMed  Google Scholar 

  36. Hupp T, Allenberg JR, Post K, Roeren T, Meier M, Clorius JH. Renal artery aneurysm: surgical indication and results. Eur J Vasc Surg. 1992;6:477–86.

    Article  CAS  PubMed  Google Scholar 

  37. Chadha M, Ahuja C. Visceral artery aneurysms: diagnosis and percutaneous management. Sem Interv Radiol. 2009;26:196–206. Controversial issues in RAAs diagnosis.

    Article  Google Scholar 

  38. Chimpiri AR, Natarajan B. Renal vascular lesions: diagnosis and endovascular management. Sem Interv Radiol. 2009;26:253–61. Controversial issues in RAAs diagnosis.

    Article  Google Scholar 

  39. Bastounis E, Pikoulis E, Georgopoulos S, et al. Surgery for renal artery aneurysms: a combined series of two large centers. Eur Urol. 1998;33:22–7.

    Article  CAS  PubMed  Google Scholar 

  40. Pfeiffer T, Reiher L, Grabitz, et al. Reconstruction for renal artery aneurysms: operative techniques and long-term results. J Vasc Surg. 2003;37:293–300.

    Article  PubMed  Google Scholar 

  41. Ansari WA, Al-Fares SA, Alzobydi A, Al-Qarni A, Ansari MAAW, Fatima S. Ruptured renal artery aneurysm in a young female, a clinical dilemma. Bombay Hosp J. 2009;51:112–4.

    Google Scholar 

  42. English WP, Pearce JD, Craven TE, et al. Surgical management of renal artery aneurysms. J Vasc Surg. 2004;40:53–60.

    Article  PubMed  Google Scholar 

  43. Sorcini A, Libertino JA. Vascular reconstruction in urology. Urol Clin N Am. 1999;26:219–34. x-xi.

    Article  CAS  Google Scholar 

  44. Zhang Z, Yang M, Song L, Tong X, Zou Y. Endovascular treatment of renal artery aneurysms and renal arteriovenous fistulas. J Vasc Surg. 2013;57:765–70. Endovascular management of RAAs current series.

    Article  PubMed  Google Scholar 

  45. Abdel-Kerim A, Cassagnes L, Alfidja A, Gageanu C, Favrolt G, Dumousset E, et al. Endovascular treatment of eight renal artery aneurysms. Acta Radiol. 2012;53:430–4. Endovascular management of RAAs current series.

    Article  PubMed  Google Scholar 

  46. Balderi A, Antonietti A, Ferro L, Peano E, Pedrazzini F, Fonio P, et al. Endovascular treatment of visceral artery aneurysms and pseudoaneurysms: our experience. Radiol Med. 2012;117:815–30. Endovascular management of RAAs current series.

    Article  CAS  PubMed  Google Scholar 

  47. Sildiroglu O, Saad WE, Hagspiel KD, Matsumoto AH, Turba UC. Endovascular management of iatrogenic native renal arterial pseudoaneurysms. Cardiovasc Intervent Radiol. 2012;35:1340–5. Endovascular management of RAAs current series.

    Article  PubMed  Google Scholar 

  48. Etezadi V, Gandhi RT, Benenati JF, Rochon P, Gordon M, Benenati MJ, et al. Endovascular treatment of visceral and renal artery aneurysms. J Vasc Interv Radiol. 2011;22:1246–53. Endovascular management of RAAs current series.

    Article  PubMed  Google Scholar 

  49. Cochennec F, Riga CV, Allaire E, Cheshire NJ, Hamady M, Jenkins MP, et al. Contemporary management of splanchnic and renal artery aneurysms: results of endovascular compared with open surgery from two European vascular centers. Eur J Vasc Endovasc Surg. 2011;42:340–6. Recent large series of RAAs: surgical and endovascular management.

    Article  CAS  PubMed  Google Scholar 

  50. Marone EM, Mascia D, Kahlberg A, Brioschi C, Tshomba Y, Chiesa R. Is open repair still the gold standard in visceral artery aneurysm management? Ann Vasc Surg. 2011;25:936–46. Recent large series of RAAs: surgical and endovascular management.

    Article  PubMed  Google Scholar 

  51. Belzer FO, Salvatierra O, Palubinskas A, Stoney RJ. Ex vivo renal artery reconstruction. Ann Surg. 1975;182:456–62.

    Article  CAS  PubMed  Google Scholar 

  52. Shirodkar SP, González J, Parodi J, Omaida V, Bird V, Burke GW, et al. Open or laparoscopic nephrectomy and extracoroporeal repair of complicated renal artery aneurysms: techniques for renal salvage. Arch Esp Urol. 2011;64:227–36. Recent series of ex vivo repair and autotransplantation for complex RAAs.

    CAS  PubMed  Google Scholar 

  53. Robinson 3rd W, Bafford R, Belkin M, Menard MT. Favorable outcomes with in situ techniques for surgical repair of complex renal artery aneurysms. J Vasc Surg. 2011;53:684–91. Recent large series of RAAs surgical management.

    Article  PubMed  Google Scholar 

  54. Giulianotti PC, Bianco FM, Addeo P, Lombardi A, Coratti A, Sbrana F. Robot-assisted laparoscopic repair of renal artery aneurysms. J Vasc Surg. 2010;51:842–9. Current series of robotic-assisted, laparoscopic surgical management for RAAs.

    Article  PubMed  Google Scholar 

  55. Chandra A, O'Connell JB, Quinones-Baldrich WJ, Lawrence PF, Moore WS, Gelabert HA, et al. Aneurysmectomy with arterial reconstruction of renal artery aneurysms in the endovascular era: a safe, effective treatment for both aneurysm and associated hypertension. Ann Vasc Surg. 2010;24:503–10. Recent series of RAAs surgical management.

    Article  PubMed  Google Scholar 

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Conflict of Interest

Dr. Javier González, Dr. Manuel Esteban, Dr. Guillermo Andrés, Dr. Estefania Linares, and Dr. Juan Ignacio Martínez-Salamanca declare that there are no conflicts of interest relevant to this article.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

Author information

Authors and Affiliations

  1. Servicio de Urología, Hospital Central de la Cruz Roja San José y Santa Adela, Avenida de Reina Victoria 22-26, 28003, Madrid, Madrid, Spain

    J. González

  2. Servicio de Urología, Hospital Nacional de Parapléjicos, Toledo, Castilla-La Mancha, Spain

    M. Esteban

  3. Servicio de Urología, Hospital Universitario de Getafe, Getafe, Madrid, Spain

    G. Andrés

  4. Servicio de Urología, Hospital Universitario Puerta de Hierro-Majadahonda, Majadahonda, Madrid, Spain

    E. Linares & J. I. Martínez-Salamanca

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  1. J. González
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  2. M. Esteban
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  3. G. Andrés
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  4. E. Linares
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  5. J. I. Martínez-Salamanca
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Correspondence to J. González.

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This article is part of the Topical Collection on Kidney Diseases

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González, J., Esteban, M., Andrés, G. et al. Renal Artery Aneurysms. Curr Urol Rep 15, 376 (2014). https://doi.org/10.1007/s11934-013-0376-z

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