eMedicine Specialties > Vascular Surgery > Medical Topics

Renal Artery Aneurysm: Follow-up

Author: Wesley K Lew, MD, Resident, Department of General Surgery, University of Southern California
Coauthor(s): Fred A Weaver, MD, Professor of Surgery, University of Southern California; Chief, Division of Vascular Surgery, Director of Noninvasive Vascular Laboratory, Program Director of Vascular Surgery, University of Southern California University Hospital;; Christian A Otero, MD, Staff Physician, Department of Surgery, Jackson Memorial Hospital, University of Miami School of Medicine; Raid Sawaqed, MD, Staff Physician, Department of General Surgery, Catholic Health Partners of Chicago; Nicholas D Garcia, MD, Chief of Surgery, Exeter Health Resources; Director, Board of Directors, Core Physician Services; Medical Director, Vascular Lab, Exeter Hospital; Mark D Morasch, MD, Associate Professor of Surgery, Division of Vascular Surgery, Northwestern University, The Feinberg School of Medicine
Contributor Information and Disclosures

Updated: Sep 17, 2008

Outcome and Prognosis

The morbidity and mortality rates associated with elective repair are very low. Many authors have reported no mortality and minimal morbidity after surgery.6,14,15
 
The prognosis after rupture of renal artery aneurysm (RAA) has improved in the last few decades. One review documented that the mortality rate dropped from 62% before 1949 to 6% after 1970.
 
Rupture of RAA during pregnancy still carries a high mortality rate. According to one report, renal artery rupture and its treatment resulted in death of the mother in 56% of the cases and death of the fetus in 78% of the cases.4
 
The cure rate of hypertension may be as high as 50-100% in selected patients with aneurysms associated with renal artery stenosis.3,6,12,14
 
Surgical repair of RAA appears to have long-term durability, although most reported series are small and from single centers.

Future and Controversies

Further refinements in endovascular techniques may allow more renal artery aneurysms (RAAs) to be treated in this manner. Gadolinium-enhanced MRA and CT angiography with 3-dimensional reconstruction have essentially replaced conventional arteriography as a diagnostic tool and for preinterventional planning. 

Controversy still exists regarding the diameter at which an asymptomatic aneurysm should be repaired. Suggested diameters range from 1.5-3 cm.6   Some reports even suggest that larger asymptomatic saccular aneurysms may be managed expectantly. Finally, the protective effect of aneurysm sac wall calcification against rupture is still debated.16

 
Acknowledgments

The authors and editors of eMedicine gratefully acknowledge the contributions of previous author Hassan Tehrani, MB, BCh, to the development and writing of this article.



More on Renal Artery Aneurysm

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Workup: Renal Artery Aneurysm
Treatment: Renal Artery Aneurysm
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Multimedia: Renal Artery Aneurysm
References
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Further Reading

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Keywords

aneurysm, renal, renal artery aneurysm (RAA), extraparenchymal aneurysm, saccular aneurysm, fusiform aneurysm, true aneurysm, false aneurysm, dissecting aneurysm, intraparenchymal aneurysm, fibromuscular dysplasia (FMD), blunt abdominal trauma, intraluminal catheter-induced injury, polyarteritis nodosa (PAN), Kawasaki disease, tuberculosis, neurofibromatosis, Ehlers-Danlos syndrome, renal artery injury, stent graft, ex vivo, extracorporeal

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Contributor Information and Disclosures

Author

Wesley K Lew, MD, Resident, Department of General Surgery, University of Southern California
Disclosure: Nothing to disclose.

Coauthor(s)

Fred A Weaver, MD, Professor of Surgery, University of Southern California; Chief, Division of Vascular Surgery, Director of Noninvasive Vascular Laboratory, Program Director of Vascular Surgery, University of Southern California University Hospital;
Fred A Weaver, MD is a member of the following medical societies: Alpha Omega Alpha, American Association for the Surgery of Trauma, American College of Surgeons, American Heart Association, American Surgical Association, Association for Academic Surgery, Peripheral Vascular Surgery Society, Phi Beta Kappa, Society for Clinical Vascular Surgery, Society for Vascular Surgery, Society of University Surgeons, and Western Surgical Association
Disclosure: CVRx Consulting fee Review panel membership

Christian A Otero, MD, Staff Physician, Department of Surgery, Jackson Memorial Hospital, University of Miami School of Medicine
Disclosure: Nothing to disclose.

Raid Sawaqed, MD, Staff Physician, Department of General Surgery, Catholic Health Partners of Chicago
Raid Sawaqed, MD is a member of the following medical societies: American College of Surgeons
Disclosure: Nothing to disclose.

Nicholas D Garcia, MD, Chief of Surgery, Exeter Health Resources; Director, Board of Directors, Core Physician Services; Medical Director, Vascular Lab, Exeter Hospital
Nicholas D Garcia, MD is a member of the following medical societies: American College of Surgeons, New Hampshire Medical Society, and Society for Vascular Surgery
Disclosure: Nothing to disclose.

Mark D Morasch, MD, Associate Professor of Surgery, Division of Vascular Surgery, Northwestern University, The Feinberg School of Medicine
Mark D Morasch, MD is a member of the following medical societies: American College of Surgeons, American Heart Association, and Central Surgical Association
Disclosure: W.L. Gore & Associates Honoraria Speaking and teaching; W.L. Gore & Associates Grant/research funds None; Cryolife Honoraria Consulting; King Pharmaceuticals  Honoraria Consulting

Medical Editor

Richard A Santucci, MD, FACS, Chief of Urology, Detroit Receiving Hospital; Specialist-in-Chief of Urology, Detroit Medical Center; Chief of Urologic Trauma Surgery, Sinai Grace Hospital; Director, The Center for Urologic Reconstruction; Clinical Professor of Urology, Michigan State College of Medicine
Richard A Santucci, MD, FACS is a member of the following medical societies: American College of Surgeons, American Urological Association, and Société Internationale d'Urologie (International Society of Urology)
Disclosure: Nothing to disclose.

Pharmacy Editor

Francisco Talavera, PharmD, PhD, Senior Pharmacy Editor, eMedicine
Disclosure: eMedicine Salary Employment

Managing Editor

Travis J Phifer, MD, Chief, Division of Vascular Surgery, Professor, Department of Surgery and Radiology, Louisiana State University Health Sciences Center in Shreveport
Travis J Phifer, MD is a member of the following medical societies: American College of Emergency Physicians, American College of Surgeons, American Medical Association, Association for Academic Surgery, Society for Academic Emergency Medicine, Society for Vascular Surgery, and Society of Critical Care Medicine
Disclosure: Nothing to disclose.

CME Editor

J Stuart Wolf Jr, MD, FACS, David A Bloom Professor of Urology, Director of Division of Minimally Invasive Urology, Department of Urology, University of Michigan
J Stuart Wolf Jr, MD, FACS is a member of the following medical societies: American College of Surgeons, American Urological Association, Catholic Medical Association, Endourological Society, Society for Urology and Engineering, Society of Laparoendoscopic Surgeons, Society of University Urologists, and Society of Urologic Oncology
Disclosure: Terumo Corporation Consulting fee Consulting; Gyrus-ACMI Honoraria Speaking and teaching

Chief Editor

William H Pearce, MD, Chief, Division of Vascular Surgery, Violet and Charles Baldwin Professor of Vascular Surgery, Department of Surgery, Northwestern University School of Medicine
William H Pearce, MD is a member of the following medical societies: American College of Surgeons, American Heart Association, American Surgical Association, Association for Academic Surgery, Association of VA Surgeons, Central Surgical Association, New York Academy of Sciences, Society for Vascular Surgery, Society of Critical Care Medicine, Society of University Surgeons, and Western Surgical Association
Disclosure: Nothing to disclose.

 
 
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