E-ISSN 1305-3612
Interventional Radiology - Original Article
Endovascular Treatment of True Renal Artery Aneurysms: a single center experience
1 Department of Radiology, Hacettepe University School of Medicine, Ankara, Turkey  
2 Department of Radiology, Eskisehir Yunus Emre State Hospital, Eskişehir, Turkey  
Diagn Interv Radiol ; : -

Abstract

 

Purpose: To report a single center’s experience of the endovascular treatment of true renal artery aneurysms, including treatment techniques and outcomes.

 

Methods: This retrospective study was designed to evaluate the treatment and follow up of true renal artery aneurysms (TRAAs) treated by a variety of endovascular interventional techniques over a period of 6 years. Six patients with nine TRAAs were found and seven of the TRAAs were treated using different combinations of coil embolization and flow diverter stents. The clinical findings, aneurysm characteristics, endovascular methods and treatment outcomes were reported.

 

Results: Seven TRAAs of 6 patients were treated with a median aneurysm size of 20 mm. Three TRAAs were treated with primary sac occlusion (one with primary coil embolization, one with balloon and stent assisted coil and glue embolization and one with amplatzer vascular occlusion device and coil embolization). The remaining 4 TRAAs of 3 patients were treated with flow diverter stents (Cardiatis, Silk, Pipeline and Surpass). Immediate clinical success was achieved in patients treated with primary sac embolization (95% CI: 29.2%-100%). Among the patients treated with flow diverter stents one patient required an additional flow diverter on 6 month follow up. The occlusion time in flow diverters ranged from 1 month-12 months (median 3.5 months) taking into account of the repeat procedure. The clinical success rate was 100% (95% CI: 29.2%-100%) on first year follow up in patients treated with flow diverters. Long term follow up was available ranging 3-52 months.  One intra procedural complication was encountered with a flow diverter during deployment which required additional stenting and tirofiban infusion. No other major complication was seen.  

 

Conclusion: Endovascular treatment is an effective and safe method offering high success rates and low morbidity in the treatment of TRAAs and may supplant surgery as primary therapy. Current experience in the use of flow diverter stents in TRAAs is limited to individual case reports and with one brand of flow diverter device. Our small numbered series of 4 TRAAs show our experience of endovascular treatment with different flow diverter brands.

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