Retrospective analysis on treatment in twenty-four patients of renal artery aneurysm_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

JIN Tao ,  ZHAO Jichun

Department of Vascular Surgery, West China Hospital, Sichuan University, Chengdu 610041, P. R. China;

Corresponding author：

ZHAO Jichun, Email: zhaojc3@163.com

Keywords：

renal artery aneurysms; open surgery; endovascular repair

DOI：

10.7507/1007-9424.201811076

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Objective To retrospective summarize the experience of endovascular repair and open surgery in the treatment of renal aneurysms in our single center.Methods Clinical data of 24 patients with renal aneurysm treated in our hospital from August 2012 to May 2018 were analyzed retrospectively. Nine patients undergoing surgical intervention were categorized as the open operation group, and ten patients who received endovascular repair were classified as the endovascular repair group. To compare and analyze the results of the two groups. Five patients who had refused surgery therapy will be analyzed separately.Results Twenty-four patients with seventeen females (70.8%) and seven males (29.2%) were enrolled in this study and nineteen patients with twenty-three aneurysms got repaired successfully. The endovascular repair group had shorter hospital stay compared with the open operation group [median: 10.5 (P₂₅ 6.3, P₇₅ 15.0) d vs. 21.0 (P₂₅ 17.0, P₇₅ 27.5) d］. One patient in the open operation group developed renal artery stenosis at 11 months after surgery and underwent reoperation by repair by successful stent placement. There were no other significant postoperative complications occurred in the two groups. No abnormal enlargement or rupture of the aneurysms were observed during the follow-up period in 5 unoperated patients.Conclusions Both open surgery and endovascular repair are effective means of treating renal artery aneurysms. Once the renal aneurysm ruptures, serious consequences will occur. Once a renal aneurysm is diagnosed, regardless of the size of the aneurysm, active surgical treatment is recommend.

Citation： JIN Tao, ZHAO Jichun. Retrospective analysis on treatment in twenty-four patients of renal artery aneurysm. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2019, 26(2): 162-167. doi: 10.7507/1007-9424.201811076 Copy

1.	Orion KC, Abularrage CJ. Renal artery aneurysms: movement toward endovascular repair. Semin Vasc Surg, 2013, 26(4): 226-232.
2.	Stanley JC, Rhodes EL, Gewertz BL, et al. Renal artery aneurysms: significance of macroaneurysms exclusive of dissections and fibrodysplastic mural dilations. Arch Surg, 1975, 110(11): 1327-1333.
3.	Klausner JQ, Lawrence PF, Harlander-Locke MP, et al. The contemporary management of renal artery aneurysms. J Vascular Surgery, 2015, 61(4): 978-984.
4.	González J, Esteban M, Andrés G, et al. Renal artery aneurysms. Curr Urol Rep, 2014, 15(1): 376.
5.	Hirsch AT, Haskal ZJ, Hertzer NR, et al. ACC/AHA Guidelines for the Management of Patients with Peripheral Arterial Disease (lower extremity, renal, mesenteric, and abdominal aortic): a collaborative report from the American Associations for Vascular Surgery/Society for Vascular Surgery, Society for Cardiovascular Angiography and Interventions, Society for Vascular Medicine and Biology, Society of Interventional Radiology, and the ACC/AHA Task Force on Practice Guidelines (writing committee to develop guidelines for the management of patients with peripheral arterial disease)—summary of recommendations. J Vasc Interv Radiol, 2006, 17(9): 1383-1398.
6.	Brownstein AJ, Erben Y, Rajaee S, et al. Natural history and management of renal artery aneurysms in a single tertiary referral center. J Vasc Surg, 2018, 68(1): 137-144.
7.	Rossi M, Rebonato A, Greco L, et al. Endovascular exclusion of visceral artery aneurysms with stent-grafts: technique and long-term follow-up. Cardiovasc Intervent Radiol, 2008, 31(1): 36-42.
8.	Giulianotti PC, Bianco FM, Addeo P, et al. Robot-assisted laparoscopic repair of renal artery aneurysms. J Vasc Surg, 2010, 51(4): 842-849.
9.	Hislop SJ, Patel SA, Abt PL, et al. Therapy of renal artery aneurysms in New York State: outcomes of patients undergoing open and endovascular repair. Ann Vasc Surg, 2009, 23(2): 194-200.
10.	Rundback JH, Rizvi A, Rozenblit GN, et al. Percutaneous stent-graft management of renal artery aneurysms. J Vasc Interv Radiol, 2000, 11(9): 1189-1193.
11.	Goldblatt H, Lynch J, Hanzal RF, et al. Studies on experimental hypertension Ⅰ. The production of persistent elevation of systolic blood pressure by means of renal ischemia. J Exp Med, 1934, 59(3): 347-379.
12.	Down LA, Papavassiliou DV, O'Rear EA. Arterial deformation with renal artery aneurysm as a basis for secondary hypertension. Biorheology, 2013, 50(1-2): 17-31.
13.	Johnston SL, Lock RJ, Gompels MM. Takayasu arteritis: a review. J Clin Pathol, 2002, 55(7): 481-486.
14.	Hupp T, Allenberg JR, Post K, et al. Renal artery aneurysm: surgical indications and results. Eur J Vasc Surg, 1992, 6(5): 477-486.
15.	Bui BT, Oliva VL, Leclerc G, et al. Renal artery aneurysm: treatment with percutaneous placement of a stent-graft. Radiology, 1995, 195(1): 181-182.
16.	Buck DB, Curran T, McCallum JC, et al. Management and outcomes of isolated renal artery aneurysms in the endovascular era. J Vasc Surg, 2016, 63(1): 77-78.
17.	Laser A, Flinn WR, Benjamin ME. Ex vivo repair of renal artery aneurysms. J Vasc Surg, 2015, 62(3): 606-609.
18.	Cerny JC, Chang C, Fry WJ. Renal artery aneurysms. Arch Surg, 1968, 96(4): 653-663.
19.	Henke PK, Cardneau JD, Rd WT, et al. Renal artery aneurysms: a 35-year clinical experience with 252 aneurysms in 168 patients. Ann Surg, 2001, 234(4): 454-462.
20.	Henke PK, Stanley JC. Renal artery aneurysms: diagnosis, management and outcomes. Minerva Chir, 2003, 58(3): 305-311.
21.	Coleman DM, Stanley JC. Renal artery aneurysms. J Vasc Surg, 2015, 62(3): 779-785.
22.	Morita K, Seki T, Iwami D, et al. Long-term outcome of single institutional experience with conservative and surgical management for renal artery aneurysm. Transplant Proc, 2012, 44(6): 1795-1799.
23.	Klausner JQ, Harlander-Locke MP, Plotnik AN, et al. Current treatment of renal artery aneurysms may be too aggressive. J Vasc Surg, 2014, 59(5): 1356-1361.
24.	Calligaro KD, Dougherty MJ. Renovascular disease: aneurysms and arteriovenous fistulae. In: Cronenwett JL, Johnston KW, eds.Rutherford's Vascular Surgery. 7th ed. Philadelphia, PA: Saunders Elsevier, 2010: 2243-2247.
25.	Seo PW. Surgical treatment of ruptured renal artery aneurysm: a report of 2 cases. Korean J Thorac Cardiovasc Surg, 2013, 46(6): 467-470.
26.	Marone EM, Mascia D, Kahlberg A, et al. Is open repair still the gold standard in visceral artery aneurysm management? Ann Vasc Surg, 2011, 25(7): 936-946.
27.	Belzer FO, Salvatierra O, Palubinskas A, et al. Ex vivo renal artery reconstruction. Ann Surg, 1975, 182(4): 456-463.
28.	Cochennec F, Riga CV, Allaire E, et al. Contemporary management of splanchnic and renal artery aneurysms: results of endovascular compared with open surgery from two European vascular centers. Eur J Vasc Endovasc Surg, 2011, 42(3): 340-346.
29.	Etezadi V, Gandhi RT, Benenati JF, et al. Endovascular treatment of visceral and renal artery aneurysms. J Vasc Interv Radiol, 2011, 22(9): 1246-1253.

1. Orion KC, Abularrage CJ. Renal artery aneurysms: movement toward endovascular repair. Semin Vasc Surg, 2013, 26(4): 226-232.
2. Stanley JC, Rhodes EL, Gewertz BL, et al. Renal artery aneurysms: significance of macroaneurysms exclusive of dissections and fibrodysplastic mural dilations. Arch Surg, 1975, 110(11): 1327-1333.
3. Klausner JQ, Lawrence PF, Harlander-Locke MP, et al. The contemporary management of renal artery aneurysms. J Vascular Surgery, 2015, 61(4): 978-984.
4. González J, Esteban M, Andrés G, et al. Renal artery aneurysms. Curr Urol Rep, 2014, 15(1): 376.
5. Hirsch AT, Haskal ZJ, Hertzer NR, et al. ACC/AHA Guidelines for the Management of Patients with Peripheral Arterial Disease (lower extremity, renal, mesenteric, and abdominal aortic): a collaborative report from the American Associations for Vascular Surgery/Society for Vascular Surgery, Society for Cardiovascular Angiography and Interventions, Society for Vascular Medicine and Biology, Society of Interventional Radiology, and the ACC/AHA Task Force on Practice Guidelines (writing committee to develop guidelines for the management of patients with peripheral arterial disease)—summary of recommendations. J Vasc Interv Radiol, 2006, 17(9): 1383-1398.
6. Brownstein AJ, Erben Y, Rajaee S, et al. Natural history and management of renal artery aneurysms in a single tertiary referral center. J Vasc Surg, 2018, 68(1): 137-144.
7. Rossi M, Rebonato A, Greco L, et al. Endovascular exclusion of visceral artery aneurysms with stent-grafts: technique and long-term follow-up. Cardiovasc Intervent Radiol, 2008, 31(1): 36-42.
8. Giulianotti PC, Bianco FM, Addeo P, et al. Robot-assisted laparoscopic repair of renal artery aneurysms. J Vasc Surg, 2010, 51(4): 842-849.
9. Hislop SJ, Patel SA, Abt PL, et al. Therapy of renal artery aneurysms in New York State: outcomes of patients undergoing open and endovascular repair. Ann Vasc Surg, 2009, 23(2): 194-200.
10. Rundback JH, Rizvi A, Rozenblit GN, et al. Percutaneous stent-graft management of renal artery aneurysms. J Vasc Interv Radiol, 2000, 11(9): 1189-1193.
11. Goldblatt H, Lynch J, Hanzal RF, et al. Studies on experimental hypertension Ⅰ. The production of persistent elevation of systolic blood pressure by means of renal ischemia. J Exp Med, 1934, 59(3): 347-379.
12. Down LA, Papavassiliou DV, O'Rear EA. Arterial deformation with renal artery aneurysm as a basis for secondary hypertension. Biorheology, 2013, 50(1-2): 17-31.
13. Johnston SL, Lock RJ, Gompels MM. Takayasu arteritis: a review. J Clin Pathol, 2002, 55(7): 481-486.
14. Hupp T, Allenberg JR, Post K, et al. Renal artery aneurysm: surgical indications and results. Eur J Vasc Surg, 1992, 6(5): 477-486.
15. Bui BT, Oliva VL, Leclerc G, et al. Renal artery aneurysm: treatment with percutaneous placement of a stent-graft. Radiology, 1995, 195(1): 181-182.
16. Buck DB, Curran T, McCallum JC, et al. Management and outcomes of isolated renal artery aneurysms in the endovascular era. J Vasc Surg, 2016, 63(1): 77-78.
17. Laser A, Flinn WR, Benjamin ME. Ex vivo repair of renal artery aneurysms. J Vasc Surg, 2015, 62(3): 606-609.
18. Cerny JC, Chang C, Fry WJ. Renal artery aneurysms. Arch Surg, 1968, 96(4): 653-663.
19. Henke PK, Cardneau JD, Rd WT, et al. Renal artery aneurysms: a 35-year clinical experience with 252 aneurysms in 168 patients. Ann Surg, 2001, 234(4): 454-462.
20. Henke PK, Stanley JC. Renal artery aneurysms: diagnosis, management and outcomes. Minerva Chir, 2003, 58(3): 305-311.
21. Coleman DM, Stanley JC. Renal artery aneurysms. J Vasc Surg, 2015, 62(3): 779-785.
22. Morita K, Seki T, Iwami D, et al. Long-term outcome of single institutional experience with conservative and surgical management for renal artery aneurysm. Transplant Proc, 2012, 44(6): 1795-1799.
23. Klausner JQ, Harlander-Locke MP, Plotnik AN, et al. Current treatment of renal artery aneurysms may be too aggressive. J Vasc Surg, 2014, 59(5): 1356-1361.
24. Calligaro KD, Dougherty MJ. Renovascular disease: aneurysms and arteriovenous fistulae. In: Cronenwett JL, Johnston KW, eds.Rutherford's Vascular Surgery. 7th ed. Philadelphia, PA: Saunders Elsevier, 2010: 2243-2247.
25. Seo PW. Surgical treatment of ruptured renal artery aneurysm: a report of 2 cases. Korean J Thorac Cardiovasc Surg, 2013, 46(6): 467-470.
26. Marone EM, Mascia D, Kahlberg A, et al. Is open repair still the gold standard in visceral artery aneurysm management? Ann Vasc Surg, 2011, 25(7): 936-946.
27. Belzer FO, Salvatierra O, Palubinskas A, et al. Ex vivo renal artery reconstruction. Ann Surg, 1975, 182(4): 456-463.
28. Cochennec F, Riga CV, Allaire E, et al. Contemporary management of splanchnic and renal artery aneurysms: results of endovascular compared with open surgery from two European vascular centers. Eur J Vasc Endovasc Surg, 2011, 42(3): 340-346.
29. Etezadi V, Gandhi RT, Benenati JF, et al. Endovascular treatment of visceral and renal artery aneurysms. J Vasc Interv Radiol, 2011, 22(9): 1246-1253.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Retrospective analysis on treatment in twenty-four patients of renal artery aneurysm

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