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Giant renal artery aneurysm: A case report
Luca Cindolo1, Manuela Ingrosso, Piergustavo De Francesco
1Urology Dept, Robotic Unit, "S. Pio da Pietrelcina" Hospital, ASL Abruzzo 2. lucacindolo@virgilio.it.
Summary
A large renal artery aneurysm (RAA) was successfully resected with nephrectomy in a 59-year-old woman. This case highlights the transabdominal approach for giant, friable RAAs, confirming planned nephrectomy is viable with adequate contralateral renal function.
Area of Science:
- Vascular Surgery
- Interventional Radiology
- Nephrology
Background:
- Giant renal artery aneurysms (RAAs) are rare vascular anomalies, often presenting with flank pain or hematuria.
- Diagnosis typically involves advanced imaging like 3D-CT and AngioCT to delineate the aneurysm and associated arteriovenous malformations (AVMs).
Observation:
- A 59-year-old woman presented with flank pain and hematuria, found to have a 12 cm right RAA with significant kidney damage.
- Imaging revealed a giant right renal arteriovenous malformation (AVM) and a patent renal artery with dilated renal cavities and reduced parenchyma.
Findings:
- The patient underwent successful open resection of the giant RAA and a right nephrectomy.
- A transabdominal approach was deemed safest due to the aneurysm's large size, friability, and right-sided location.
Implications:
- This case supports planned nephrectomy for large RAAs when contralateral renal function is adequate.
- The transabdominal approach offers a safe surgical option for complex, large, and friable renal artery aneurysms.
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