Management of wide-based renal artery aneurysms using noncovered stent-assisted coil embolization

J Vasc Surg. 2017 Sep;66(3):850-857. doi: 10.1016/j.jvs.2017.04.035. Epub 2017 Jun 19.

Abstract

Objective: This study describes the safety and midterm efficacy of a noncovered stent-assisted embolization (SAE) technique in treating patients with wide-base renal artery aneurysms (RAAs).

Methods: Between February 2011 and June 2014, 34 RAAs in 28 consecutive patients were treated with noncovered SAE in our center.

Results: Technical success was 100%. During an average follow-up of 19 months, the systolic and diastolic blood pressures were significantly decreased. Serum creatinine was significantly decreased, and the glomerular filtration rate was significantly increased at the 6 and 12 month follow-up compared with the baseline. The aneurysm sac thrombosis ratio was obviously increased at 1, 6, and 12 months of follow-up. Complications occurred in four patients, including one major, two minor, and one late complication. Computed tomography angiography or digital subtraction angiography demonstrated that the primary patency at 1, 6, and 12 months was 100%, 96%, and 100%, respectively, and primary assisted and secondary patency was 100%, without endoleaks.

Conclusions: SAE can be safely and effectively performed in patients with wide-based RAAs or those with critical anatomy. It showed a midterm reduction of blood pressure and improvement of renal function in RAA patients.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aneurysm / diagnostic imaging
  • Aneurysm / physiopathology
  • Aneurysm / therapy*
  • Angiography, Digital Subtraction
  • Biomarkers / blood
  • Blood Pressure
  • China
  • Computed Tomography Angiography
  • Creatinine / blood
  • Embolization, Therapeutic / adverse effects
  • Embolization, Therapeutic / instrumentation*
  • Endovascular Procedures / adverse effects
  • Endovascular Procedures / instrumentation*
  • Female
  • Glomerular Filtration Rate
  • Humans
  • Kaplan-Meier Estimate
  • Male
  • Middle Aged
  • Renal Artery* / diagnostic imaging
  • Renal Artery* / physiopathology
  • Retrospective Studies
  • Stents*
  • Time Factors
  • Treatment Outcome
  • Vascular Patency

Substances

  • Biomarkers
  • Creatinine