Renal artery aneurysm
Updates to Article Attributes
Renal artery aneurysms (RAA's) are considered the second most common visceral aneurysm (15-22%), most common being splenic artery aneurysm (60%). It is more common in females. Most of the lesions are saccular and tend to occur at the bifurcation of main renal artery 1.
Clinical presentation
Most cases are asymptomatic. Symptoms usually arise from rupture of aneurysm, embolization of peripheral vascular bed or arterial thrombosis 1. Hypertension is associated in up to 73% cases of these aneurysm. Haematuria has also been reported in many cases.
Pathology
Aetiology 1-2
- fibromuscular dysplasia
- degenerative aneurysm
- vasculitides (e.g. Behcet's disease)
-
phakomatosisphakomatoses (e.g. tuberous sclerosis, neurofibromatosis) - intrinsic collagen deficiency (Marfan syndrome, Ehlers-Danlos syndrome)
- trauma
Radiographic features
CT
Contrast filled outpouching/mass lesion in the region or course of renal artery.
Angiography
Aneurysms can be well detected and characterized by angiography, in terms of size, neck diameter and type.
Treatment and prognosis
Management depends on various factors like age, sex, severity of hypertension, any anticipated pregnancy and aneurysm morphology. Surgical treatment is recommended in aneurysms >2 cm in size. In any young female with anticipated pregnancy, embolization or endovascular intervention is suggested. Pregnancy associated RAA rupture are associated with 80% mortality. Follow-up is advised in aneurysms less than 2 cm. Modality of management depends on location:
- branch RAA: embolization
- main renal artery RAA: ligation and bypass surgery, nephrectomy or stent placement
-<p><strong>Renal artery aneurysms (RAA)</strong> are considered the second most common visceral aneurysm (15-22%), most common being <a href="/articles/splenic-artery-aneurysm">splenic artery aneurysm</a> (60%). It is more common in females. Most of the lesions are saccular and tend to occur at the bifurcation of main renal artery<sup> 1</sup>.</p><h4>Clinical presentation</h4><p>Most cases are asymptomatic. Symptoms usually arise from rupture of aneurysm, embolization of peripheral vascular bed or arterial thrombosis<sup> 1</sup>. Hypertension is associated in up to 73% cases of these aneurysm. Haematuria has also been reported in many cases.</p><h4>Pathology</h4><h5>Aetiology<sup> 1-2</sup>- +<p><strong>Renal artery aneurysms (RAA's)</strong> are considered the second most common visceral aneurysm (15-22%), most common being <a href="/articles/splenic-artery-aneurysm">splenic artery aneurysm</a> (60%). It is more common in females. Most of the lesions are saccular and tend to occur at the bifurcation of main renal artery<sup> 1</sup>.</p><h4>Clinical presentation</h4><p>Most cases are asymptomatic. Symptoms usually arise from rupture of aneurysm, embolization of peripheral vascular bed or arterial thrombosis<sup> 1</sup>. Hypertension is associated in up to 73% cases of these aneurysm. Haematuria has also been reported in many cases.</p><h4>Pathology</h4><h5>Aetiology<sup> 1-2</sup>
-<li>phakomatosis (e.g. tuberous sclerosis, neurofibromatosis)</li>- +<li>
- +<a title="Phakomatoses" href="/articles/phakomatoses">phakomatoses </a>(e.g. tuberous sclerosis, neurofibromatosis)</li>
References changed:
- 3. Shonai T, Koito K, Ichimura T et-al. Renal artery aneurysm: evaluation with color Doppler ultrasonography before and after percutaneous transarterial embolization. J Ultrasound Med. 2000;19 (4): 277-80. <a href="http://www.ncbi.nlm.nih.gov/pubmed/10759352">Pubmed citation</a><span class="auto"></span>
- 4. Cianci R, Stivali G, Zaccaria A et-al. Renal artery aneurysm in a solitary kidney. J Clin Ultrasound. 2008;36 (8): 500-3. <a href="http://dx.doi.org/10.1002/jcu.20369">doi:10.1002/jcu.20369</a> - <a href="http://www.ncbi.nlm.nih.gov/pubmed/17680595">Pubmed citation</a><span class="auto"></span>
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