Angiographically discovered, non-operated renal artery aneurysms

Angiographies (a total of approximately 9 500) and patient records revealed 56 patients with renal artery aneurysm during the period 1960 to 1974. Fifteen patients were operated upon electively and 3 were lost for follow-up. Rupture occurred in four leading to acute nephrectomy. Thus, 34 patients were left for studies on the natural course. They were 29-82 years old (mean 58 years) at diagnosis and were followed for at least 90 months. Twelve were males and 22 females. The aneurysms had a diameter of 3-25 mm (mean 12 mm), were fusiform in 7 and saccular in 27 cases; 9 were calcified. Repeated angiographies were carried out in 7 patients at intervals of up to 73 months showing slight enlargement of one aneurysm, disappearance of another and no change in 5. Sixteen patients were alive at the end of the follow-up period 90-220 months (mean 157 months) after the first or only angiography. Eighteen patients died after 2-204 months (mean 84 months), 14 of cardiovascular disease unrelated to the renal arteries, 3 of malignant tumour and one of pancreatitis. Autopsy in 12 patients did not show rupture of any renal artery aneurysm. Thus, in a considerable number of patients the disorder was uncomplicated and compatible with a long life.