| Sub-title | |
| Authors | P Andrejevic A R Attard |
| Abstract | Renal artery aneurysms (RAA) are rare. Based on autopsy studies, the incidence is 0.01%. However, selected patients who undergo renal arteriography have an incidence of 0.3 1%. Most RAAs are asymptomatic, although the incidence rate of hypertension in these patients may be as high as 90%. There is still some controversy regarding the need for repair of asymptomatic RAAs, but in recent years surgery is being increasingly recommended for RAAs greater than 2.0cm in diameter. Treatment options have included stenting, patch repair and bypass grafting. However, these techniques are not appropriate for most intrahilar RAAs where one or more of the segmental arteries may be involved. For these patients, nephrectomy has been recommended in the past. In recent years there has been increased interest in ex vivo repair of such aneurysms with auto-transplantation of the kidney, although such procedures have been predominantly performed in larger tertiary referral centres. We report the case of a 46 year old gentleman who was found to have a 3.4 cm aneurysm of the left renal artery during the course of ultrasonography for non-specific abdominal pain and was found to have hypertension on routine examination. This was an intrahilar aneurysm involving all 3 segmental renal arteries. The aneurysm was successfully repaired by ex vivo bench surgery and auto-transplantation. Kidney function remains normal 1 year post surgery. This case illustrates the point that complex surgery is possible in surgical units with a small catchment population but the outcome of such procedures should be constantly monitored and audited to ensure that acceptable results are being achieved. |
Published in: | |
| Journal | Malta Medical Journal |
| Volume | Volume 15 (suppl) |
| Pages | - |
| Date | |
| Link to journal | |
| Key words | renal artery aneurysm, ex-vivo repair, auto-transplantation |