Endoluminal treatment of renal artery aneurysm

Abstract

Renal artery aneurysms (RAA), are infrequent vascular anomalies, that when complicated, can lead to serious consequences. The purpose of this presentation of cases and review is to update the treatment of this entity paying special attention to endovascular approach. We present four cases; the first treated with a covered stent, the second, excluded with coils, the third treated with a flow
diverter stent and the last case managed pharmacologically. Traditionally, RAAs has been treated surgically, with complication rates close to 8%. Currently, most RAAs are treated by endovascular techniques which are constantly evolving. As with surgical
procedures, the endovascular options depend on the anatomical characteristics of the lesion, the available devices and the experience and skill of the interventional cardiologist. The techniques of endovascular treatment are divided into two categories, those involving embolization with liquid or metallic material and the techniques that use coated or flow diverter stents. These techniques alone or combined, are safe and feasible treatment options, although more studies, with long-term follow-up, are needed to demonstrate their effectiveness. Conservative treatment is reserved for aneurysms smaller than 20 mm and surgery reserved for aneurysms that are not anatomically favorable for endovascular techniques.