Endovascular Treatment for a Large Saccular Renal Artery Aneurysm to Avoid Nephrectomy: Report of a Case

Abstract

Endovascular treatment for renal artery aneurysms has been reported with good results. A large saccular aneurysm (25 mm×30 mm×30 mm) in the anterior branch of the left renal artery in a healthy 34-year-old man had a broad-base neck of 11 mm with a neck-to-dome ratio of 2.3. The aneurysm was considered unsuitable for coil embolization, and a covered stent would have occluded the other segmental artery. A stent for coronary artery (Xience Skypoint) was placed in the target vessel to cover the aneurysmal neck, and the aneurysm was adequately filled with coils. This procedure was considered to provide sufficient filling of coils even for aneurysms unsuitable for coil embolization. The patient was discharged on the second postoperative day without any complications. On the other hand, we initially selected a stent so that it was landed approximately 4 mm proximal and distal of the aneurysm, but it fell into the aneurysm because its length was shorter than expected to need stent-landing sufficiently. Thus, we delivered an additional stent long enough. Endovascular treatment for renal artery aneurysms with good short-term results has been established, and experiences of device selection and mid- to long-term outcomes would like to be accumulated.