Embolization of ruptured renal artery aneurysms

Renal artery aneurysm (RAA) is a relatively rare vascular entity. Treatment of ruptured RAA could be either surgical or via an endovascular route with variable prognosis and remain controversial. To evaluate the results of ruptured renal artery aneurysms treated by endovascular treatment and explore the efficacy of selective embolization in ruptured RAAs, controlling hemorrhage, and preserving renal function.

From January 2001 to May 2011, 6 patients presented with gross hematuria or sudden onset severe abdominal or flank pain. This included a number in whom the aneurysm leaked, causing hematuria. Color Doppler ultrasonography (CDU) and contrasted computed tomography (CT) or computed tomography angiography (CTA) demonstrated 6 cases, and all cases were performed emergency angiography and 5 cases treated with selective coil embolization, and one case with trunk artery occlusion.

All cases with a follow-up for mean 25 months (range 12-64 months),4 cases with selective coil embolization with complete durable occlusion was achieved in all aneurysms without relapse, patients' renal function was not significantly deteriorated. The case with trunk occlusion underwent subsequent ischemic parenchymal loss and post-embolization syndrome and with mild kidney atrophy.

Superselective coil embolization provides a good therapeutic option for the ruptured RAAs with low mortality rates and good long-term outcome. RAAs have a probability of bilateral and multiple lesions,so attention for the presence of the contralateral RAA is important for medical choice.