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December 23, 2005
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Neal S. Cayne, MD, Srephanie S. Saltzberg, Ken Goldstein, Caron Rockman, Patrick J. Lamparello, Glenn Jacobowitz, Thomas Maldonado, Joseph E. Glaser, Mark Adelman, Thomas Riles.
NYU Medical Center, New York, NY, USA.
OBJECTIVES: This study reports our experience with renal artery aneurysms(RAAs).
METHODS: We performed a retrospective review of all patients evaluated by the New York University Vascular Surgery Department from 1998 to 2005. Twenty-three patients(13 males/10 females) were identified with RAAs. Average age was 65±17years. Eleven patients underwent either open surgery(n=6) or percutaneous intervention(n=5). Indications for RAA treatment were size >2.0 cm(11/11), identification of the RAA during pregnancy(1/11), RAA in a non-pregnant female of child bearing age(2/11), symptoms of hypertension and/or pain (4/11) and a concomitant ipsilateral renal cell cancer(1/11). The remaining twelve RAA patients were observed.
RESULTS: Two of 5 patients treated via an endovascular approach underwent successful exclusion with placement of an endovascular graft. The remaining 3 endovascular patients had saccular aneurysms that were amenable to coil embolization. Five of the six patients requiring open surgery for their RAA had a primary aneurysmectomy and arterioplasty with, or without vein patch closure. One patient required open surgery with nephrectomy for a concomitant ipsilateral renal cell cancer. Average length of stay was 2.8 days for the endovascular patients and 6.7 days for the open surgical patients. There was no 30-day mortality or decline in renal function in either the endovascular or open surgical group. The observed group had an average RAA size of 1.6 cm±.5cm, with an average RAA growth rate of <1mm/year. Mean follow-up was 48 months. There were no aneurysm ruptures or deaths.
CONCLUSIONS: RAAs can be safely treated via an endovascular or open approach. In appropriately selected patients, an endovascular approach can offer successful exclusion with a shorter hospital stay. RAAs <2.0 cm have a slow rate of growth and may be observed in asymptomatic patients who are not females in their child bearing years.
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Twenty-three Cases of Renal Artery Aneurysms: A 7-Year Experience From a Single Institution
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Neal S. Cayne, MD, Srephanie S. Saltzberg, Ken Goldstein, Caron Rockman, Patrick J. Lamparello, Glenn Jacobowitz, Thomas Maldonado, Joseph E. Glaser, Mark Adelman, Thomas Riles.
NYU Medical Center, New York, NY, USA.
OBJECTIVES: This study reports our experience with renal artery aneurysms(RAAs).
METHODS: We performed a retrospective review of all patients evaluated by the New York University Vascular Surgery Department from 1998 to 2005. Twenty-three patients(13 males/10 females) were identified with RAAs. Average age was 65±17years. Eleven patients underwent either open surgery(n=6) or percutaneous intervention(n=5). Indications for RAA treatment were size >2.0 cm(11/11), identification of the RAA during pregnancy(1/11), RAA in a non-pregnant female of child bearing age(2/11), symptoms of hypertension and/or pain (4/11) and a concomitant ipsilateral renal cell cancer(1/11). The remaining twelve RAA patients were observed.
RESULTS: Two of 5 patients treated via an endovascular approach underwent successful exclusion with placement of an endovascular graft. The remaining 3 endovascular patients had saccular aneurysms that were amenable to coil embolization. Five of the six patients requiring open surgery for their RAA had a primary aneurysmectomy and arterioplasty with, or without vein patch closure. One patient required open surgery with nephrectomy for a concomitant ipsilateral renal cell cancer. Average length of stay was 2.8 days for the endovascular patients and 6.7 days for the open surgical patients. There was no 30-day mortality or decline in renal function in either the endovascular or open surgical group. The observed group had an average RAA size of 1.6 cm±.5cm, with an average RAA growth rate of <1mm/year. Mean follow-up was 48 months. There were no aneurysm ruptures or deaths.
CONCLUSIONS: RAAs can be safely treated via an endovascular or open approach. In appropriately selected patients, an endovascular approach can offer successful exclusion with a shorter hospital stay. RAAs <2.0 cm have a slow rate of growth and may be observed in asymptomatic patients who are not females in their child bearing years.
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