July 27, 2010

Renal Artery Aneurysm

Axial CT image shows a large partially thrombosed aneurysm of the right renal artery, which is extraparenchymal. On other images, the aneurysm is saccular, and appears to arise from the segmental artery.

  • True aneurysms involve all layers of the artery and usually inherited. They can be fusiform or saccular, and are more commonly extraparenchymal in location. Example: fibromuscular dysplasia, Ehlers-Danlos
  • False aneurysms involve only some layers of the artery, usually are acquired and saccular. Examples: trauma, iatrogenic, dissection, mycotic
  • Intrarenal aneurysms are intraparenchymal, can be either true or false aneurysm. Examples: polyarteritis nodosa, tuberculosis, neurofibromatosis
Indications for Intervention
  • Symptomatic: rupture, pain, ischemia, infarction, hypertension
  • Diameter more than 2 cm, enlarging or dissection
  • Female patient who is pregnant, or contemplating pregnancy
Our case: False aneurysm probably due to dissection, surgical removal was performed in this symptomatic patient

Lew WK, Weaver FA, Otero CA, et al. Renal artery aneurysm. E-medicine, updated September 17, 2008

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