title: Incidence of renal artery pseudoaneurysm following open and minimally invasive partial nephrectomy: a systematic review and comparative analysis.
abstract: OBJECTIVE
  Partial nephrectomy is performed for renal masses as a means of preserving renal function. Renal artery pseudoaneurysm is a potential complication of partial nephrectomy. We determined the incidence of renal artery pseudoaneurysm after open and minimally invasive partial nephrectomy, and performed a comparative analysis.
  
  
  METHODS
  We queried the Ovid Medline® and PubMed® databases to locate published reports of renal artery pseudoaneurysm after partial nephrectomy. Studies were included in comparative analysis if they were in English and showed the total number of procedures performed and perioperative complications.
  
  
  RESULTS
  Included studies represented a total of 5,229 patients, of whom 2,494 and 2,735 underwent open and minimally invasive partial nephrectomy, respectively. A total of 25 and 52 renal artery pseudoaneurysms were reported after open and minimally invasive procedures (weighted 1.00% and 1.96%, respectively). The difference between these 2 values was statistically significant (p ≤ 0.001). Patients diagnosed with renal artery pseudoaneurysm presented a mean of 14.9 days after surgery and 87.3% of them had gross hematuria at presentation. Almost all patients with renal artery pseudoaneurysm were treated with percutaneous angioembolization with 96% success.
  
  
  CONCLUSIONS
  Although it is rare, the risk of renal artery pseudoaneurysm after partial nephrectomy is significant and should be high on the differential for a patient who presents postoperatively with gross hematuria. The incidence of renal artery pseudoaneurysm is higher after minimally invasive partial nephrectomy than after an open approach. Angioembolization for renal artery pseudoaneurysm after partial nephrectomy offers an excellent success rate and minimal patient morbidity.
authors.affiliation: University of Toledo Medical Center, Toledo, Ohio 43614, USA. samay.jain@utoledo.edu
authors.forename: Samay
authors.initials: S
authors.lastname: Jain
authors.forename: Themba
authors.initials: T
authors.lastname: Nyirenda
authors.forename: Jennifer
authors.initials: J
authors.lastname: Yates
authors.forename: Ravi
authors.initials: R
authors.lastname: Munver
mesh_terms: D017541:Aneurysm, False / Q000453:epidemiology* / Q000209:etiology*; D006801:Humans; D015994:Incidence; D019060:Minimally Invasive Surgical Procedures; D009392:Nephrectomy / Q000009:adverse effects* / Q000379:methods*; D012077:Renal Artery