[Aneurysms of the renal artery. Personal experience in 101 cases]

The authors operated on 101 aneurysms of the renal artery in 97 patients. A great majority of the patients had dysplastic aneurysms. In most cases, the aneurysm was associated with other lesions: of the renal artery (41 cases), of the kidney (17 cases), of the aorta or of other visceral arteries (10 cases) or of other organs (4 cases). Renal artery dysplastic aneurysms are usually saccular and have a fibrous neck. Their walls are frequently very thin, predisposing to rupture. Intrasaccular thrombosis is rare. In nearly all patients, the aneurysms were discovered on angiography performed because of arterial hypertension. When no stenosis of the renal artery is present, the aneurysm itself cannot be held responsible for the hypertension. Treatment consisted of 16 nephrectomies and 85 arterial repairs; 16 of the repairs were performed by ex situ surgery. Modalities of repairs depend on anatomical arrangement of the vessels. Use of an arterial substitute is optional: an arterial autograft is the material of choice. Surgical repair protects against the threat of aneurysmal rupture. Arterial hypertension is cured only when an associated stenosis has been repaired. Surgical treatment is recommended in most cases. Failures have considerably decreased with experience and the use of ex situ repair.