Clinical efficacy analysis of endovascular intervention for renal artery aneurysm

doi:10.3877/cma.j.issn.2095-5782.2024.02.007

Abstract

Abstract:

Objective

To investigate the clinical efficacy and diagnosis and treatment experience of endovascular treatment for renal artery aneurysm (RAA).

Methods

Retrospective analysis of surgical data and clinical outcomes of 14 patients with RAA treated with endovascular intervention admitted to the First Hospital of Soochow University from 03, 2016 to 02, 2023. The preoperative and postoperative clinical manifestations, imaging manifestations, renal function, and the occurrence of intraoperative and postoperative complications were recorded.

Results

Among the 14 patients, there were 2 cases of type Ⅰ RAA, in which the aneurysm were located in the main trunk of the renal artery; 7 cases of type Ⅱ RAA, in which the aneurysm was located in the bifurcation of the renal artery; 5 cases of type Ⅲ RAA, in which the aneurysm originated from the intrarenal vessels. The mean maximum diameter of the aneurysms was (21.8 ± 11.4) mm (11~57 mm), the mean basal width was (6.9 ± 2.7) mm (4.0~15.0 mm), and the mean diameter of the aneurysm-carrying artery was (3.9 ± 1.0) mm (1.8~5.1 mm). All 14 patients with RAA were successfully treated with endovascular intervention, using embolization of the aneurysm in 12 cases, covered stent placement in 1 case, and embolization of the aneurysm-carrying artery in 1 case, and the success rate was 100%. Five patients with lumbar and abdominal pain had relief of symptoms, and five patients with hypertension had their blood pressure reduced to normal after endoluminal intervention. There was no recurrence of aneurysm and no serious complications during the follow-up period which was with a mean of (20.1 ± 18.4) months.

Conclusion

Endovascular intervention for RAA is safe and effective. Spring-coil embolization can be combined with stent-graft and balloon to treat more complex cases.

Key words: Renal artery aneurysm, Spring-coil embolization, Stent-graft, Interventional therapy

Xiaoyang Xu, Shuai Zhang, Binyan Zhong, Jian Shen, Xiaoli Zhu. Clinical efficacy analysis of endovascular intervention for renal artery aneurysm[J]. Chinese Journal of Interventional Radiology(Electronic Edition), 2024, 12(02): 137-143.

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Figures/Tables 6

References 27

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临床资料	数值（n = 14）
男（n）	8
女（n）	6
年龄（岁）	52.1 ± 9.9
BMI	25.8 ± 3.3
伴高血压[n（%）]	7（50.0）
无症状[n（%）]	5（35.7）
腰痛[n（%）]	5（35.7）
血尿[n（%）]	0（0.0）
动脉瘤数（n）
1枚	13
3枚	1
动脉瘤大小（mm）	21.8 ± 11.4
基底宽度（mm）	6.9 ± 2.7
颈/体比值	0.34 ± 0.11
载瘤动脉直径（mm）	3.9 ± 1.0
Rundback分型[n（%）]
Ⅰ型	2（14.3）
Ⅱ型	7（50.0）
Ⅲ型	5（35.7）

临床资料	数值（n = 14）
男（n）	8
女（n）	6
年龄（岁）	52.1 ± 9.9
BMI	25.8 ± 3.3
伴高血压[n（%）]	7（50.0）
无症状[n（%）]	5（35.7）
腰痛[n（%）]	5（35.7）
血尿[n（%）]	0（0.0）
动脉瘤数（n）
1枚	13
3枚	1
动脉瘤大小（mm）	21.8 ± 11.4
基底宽度（mm）	6.9 ± 2.7
颈/体比值	0.34 ± 0.11
载瘤动脉直径（mm）	3.9 ± 1.0
Rundback分型[n（%）]
Ⅰ型	2（14.3）
Ⅱ型	7（50.0）
Ⅲ型	5（35.7）

分型	治疗方法				术前血压（mmHg）	术后血压（mmHg）	术前肌酐(μmoI/L)	术后肌酐(μmoI/L)	瘤体增大/破裂数（例）	死亡数（例）
分型	覆膜支架	支架辅助栓塞	瘤腔栓塞	载瘤动脉栓塞	术前血压（mmHg）	术后血压（mmHg）	术前肌酐(μmoI/L)	术后肌酐(μmoI/L)	瘤体增大/破裂数（例）	死亡数（例）
Ⅰ型	1	0	1	0	148 ± 16/82 ± 22	121 ± 10/71 ± 10	65.1 ± 15.5	62.3 ± 18.1	0	0
Ⅱ型	0	0	7	0	137 ± 19/83 ± 15	127 ± 16/76 ± 15	78.7 ± 19.5	72.8 ± 14.9	0	0
Ⅲ型	0	0	4	1	140 ± 19/85 ± 8	128 ± 13/79 ± 14	58.1 ± 12.2	57.1 ± 14.6	0	0

分型	治疗方法				术前血压（mmHg）	术后血压（mmHg）	术前肌酐(μmoI/L)	术后肌酐(μmoI/L)	瘤体增大/破裂数（例）	死亡数（例）
分型	覆膜支架	支架辅助栓塞	瘤腔栓塞	载瘤动脉栓塞	术前血压（mmHg）	术后血压（mmHg）	术前肌酐(μmoI/L)	术后肌酐(μmoI/L)	瘤体增大/破裂数（例）	死亡数（例）
Ⅰ型	1	0	1	0	148 ± 16/82 ± 22	121 ± 10/71 ± 10	65.1 ± 15.5	62.3 ± 18.1	0	0
Ⅱ型	0	0	7	0	137 ± 19/83 ± 15	127 ± 16/76 ± 15	78.7 ± 19.5	72.8 ± 14.9	0	0
Ⅲ型	0	0	4	1	140 ± 19/85 ± 8	128 ± 13/79 ± 14	58.1 ± 12.2	57.1 ± 14.6	0	0

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