4 research outputs found
Surgery for renal artery aneurysms: A combined series of two large centers
Objective: To review the clinical features and results of surgical
treatment of renal artery aneurysms from two large centers. Patients and
Methods: A retrospective analysis of 21 hypertensive patients with renal
artery aneurysms operated in two centers during a 24-year period was
performed. Results: The presenting symptom was subcostal or flank pain
in 8 (38%) and hematuria in 5 (24%) cases. A ring-like calcification
was seen on plain X-ray in 6 (29%) cases. All patients were evaluated
with renal angiography showing a saccular aneurysm in 13 cases (62%),
fusiform in 5 (24%) and dissecting in 3 (14%) cases. All saccular
aneurysms were treated with resection followed by reconstruction with
vein patch in 10 cases, and with and end-to-end anastomosis in 3 cases.
All fusiform and dissecting aneurysms were managed with resection and
reconstruction using aortorenal bypass. There was no hospital mortality
or significant morbidity. During a follow-up ranging from 6 months to 23
years, there was definite cure of hypertension in 14 (67%) patients and
improvement of blood pressure levels in 4 (19%) patients. Three
patients continued to be hypertensive. Conclusion: Surgery for renal
artery aneurysms can be accomplished with good results and should be
considered for patients with aneurysms greater than 2 cm, for aneurysms
causing renovascular hypertension, significant stenosis, flank pain, or
hematuria, for dissecting, expanding and thrombotic aneurysms, and in
women with a potential for pregnancy. However, all aneurysms cannot and
should not be treated surgically