Endovascular repair of a ruptured renal artery aneurysm.
OBJECTIVE
To describe the percutaneous treatment of a ruptured renal artery aneurysm (RAA) using a stent-graft.


METHODS
An 86-year-old woman had sudden onset of right-sided back pain and a swollen left leg. Computed tomography disclosed a right retroperitoneal mass involving the kidney; the inferior vena cava was compressed, with thrombus in the left common iliac artery. There was a suggestion of RAA associated with contrast extravasation. Angiography confirmed a saccular aneurysm of the distal right main renal artery immediately proximal to the first segmental branch. A Jostent peripheral stent-graft was implanted with complete exclusion of the lesion. At 6-month follow-up, the patient remained asymptomatic, but there was a suggestion of in-stent restenosis, which is being followed closely.


CONCLUSIONS
In elderly patients who are hemodynamically stable and have aneurysm anatomy that is suitable for stent-graft placement, the endovascular approach may allow rapid and definitive treatment of the hemorrhage.
Schneidereit
Nathan P
NP
Division of General Surgery, Vancouver General Hospital, University of British Columbia, Canada.
Lee
Shung
S
Morris
D Christopher
DC
Chen
Jerry C
JC
D000368:Aged; D000369:Aged, 80 and over; D017542:Aneurysm, Ruptured / Q000000981:diagnostic imaging / Q000601:surgery*; D000792:Angiography; D019917:Blood Vessel Prosthesis Implantation; D005260:Female; D006801:Humans; D012077:Renal Artery / Q000000981:diagnostic imaging / Q000601:surgery*; D015607:Stents; D014057:Tomography, X-Ray Computed