[Renal artery aneurysms]

Between 1980 and 1990, 21 patients with 26 renal artery aneurysms (0.4-16.5 cm in diameter) were diagnosed and treated at the Surgical Center, University of Heidelberg. Surgical reconstructive methods were applied to treat extrarenal and interventional embolization to treat intrarenal aneurysms. The most effective diagnostic method is selective intraarterial angiography. The etiology, age distribution, localization and clinical aspects are discussed. Four bleeding intrarenal aneurysms were embolized with full preservation of renal function (one solitary kidney). After surgical reconstruction of the aneurysmatic vessel, 80% of the hypertensive patients turned normotensive. Follow-up of a nontreated sacciform aneurysm showed total thrombosis within 4 years. In the same period, fixed renal hypertension developed in the patient because of recurrent microembolism in the renal parenchyma. Therefore, we suggest immediate treatment of a renal aneurysm to prevent the development of renal hypertension.