How to manage distal renal artery aneurysm

Explore this special case featuring a patient with a history of prostate cancer and an intriguing discovery of a sacciform left renal artery aneurysm measuring 10mm.

Maxime Raux

Hospital: Paris Saint-Joseph, France

Part I - Medical history

Previous medical history: prostate cancer (2018). Assessment reveals a sacciform left renal artery aneurysm (10mm)
Risk Factors: hypercholesterolemia
Current state: annual ultrasound follow-up, with a rapid growth aneurysm (up to 25 mm), and recent abdominal pain in the left upper quadrant

Part II : Guidelines and Aneurysm characteristics

Guidelines

Aneurysm characteristics

Sacciform aneurysm, 20 x 25 mm diameter, just before artery’s bifurcation. Native artery above is 6 mm diameter and a broad neck 7 x 9 mm.

Part III - Treatment and conclusion

Acces with a 7 Fr APTUS

Catheterization of the main distal renal artery with a 0,014 wire and the aneurysm with a 2,7 Fr Progreat Micro catheter

Under fusion Imaging, placement of uncovered balloon expandable bare metal stent (Abbott, Herculink, 6x12 mm) in front of the neck to prevent from coil migration

Embolization using detachabale coils 3D CONCERTO Helix 20 mmx50 cm

Completing with 16x40 and 14x30 cm

Final Angio