Long-term follow-up of endovascular treatment of renal artery aneurysms with covered stent deployment.

BACKGROUND: The aim of this study was to assess the technical success and clinical long-term results of renal artery aneurysm (RAA) treatment using covered stents.

METHODS: We performed a retrospective study on endovascular treatment of nine patients with 10 RAAs, arising from the main renal artery or from the proximal portion of large segmental arteries. All procedures were performed in our department between 2004 and 2011. The aneurysms were excluded using covered stents. Our follow-up included laboratories indexes, Computed Tomography-angiography (CTA) at 1-6-12-24 months and 48-month Duplex-ultrasound examination.

RESULTS: Study population included 4 males and 5 females (mean age: 63.5±7.3 y.o.). Six were affected by fibromuscular dysplasia and associated renal artery stenosis. The population showed a significant decrease of arterial blood pressure (from baseline values of 163.9±19.4/98.9±9.2 mmHg to 128.9±6.5/79.4±4.6 mmHg at 24 months follow-up) and of drug posology (baseline 3.7±0.7 drugs to 1.6±0.7 drugs at 24 months). Also they showed a significant decrease of serum creatinine levels (baseline 1.9±1.4 mg/dL vs.1.1±0.4 mg/dL at 12 months) and increase of glomerular filtration rate (from baseline values 46.9±23 mL/min/1.73 m2 to 69.1±20 mL/min/1.73 m2 at 24 months follow-up). CTA demonstrated patency of the cover stents, absence of endoleaks and re-stenosis in all patients. Only in one patient the inferior segmental artery was sacrificed due to the presence of its early origin, resulting in a small area of renal parenchyma infarction with no significant clinical consequences.

CONCLUSIONS: The procedure revealed to be safe for renal function, feasible and effective for the exclusion of the aneurismal sac and restoring vessel patency.