Renal artery aneurysm

Selective treatment for hypertension and prevention of rupture

Raymond S. Martin, Patrick W. Meacham, Jeff A. Ditesheim, Joseph L. Mulherin, William Edwards

    Research output: Contribution to journalArticle

    97 Citations (Scopus)

    Abstract

    Thirty-nine patients with renal artery aneurysm (RAA) were seen over a period of 15 years. Among 20 women and 19 men, 31 were found to have solitary aneurysms, and eight had multiple RAA. Thirty-three patients had diastolic hypertension; nine of them proved to be of renovascular origin. Of the 18 patients who underwent RAA resection, 13 had reconstruction for treatment of hypertension, three had a solitary functional kidney, one had recurrent flank pain, and one had resection for prevention of rupture in a woman of childbearing age. Six of the 18 patients had aneurysmorrhaphy with primary repair or patching, seven had a resection with an aortorenal bypass, and five patients had six ex vivo renal reconstructions with multiple anastomoses. Nephrectomy was performed in two patients with RAA rupture at the time of childbirth and in one patient with hypertension and RAA in a poorly functioning kidney. Reconstructive procedures for documented renovascular hypertension in seven patients resulted in improvement in all cases. Blood pressure improved in only six of 10 patients operated on with hypertension and no lateralization of renovascular studies. Eighteen patients were observed for one to 16 years without surgery, and none experienced rupture. Resection of RAA is indicated to treat patients with renovascular hypertension, patients with hypertension and a solitary functional kidney, and selected patients with severe hypertension and to prevent rupture in women who may become pregnant. Other patients with asymptomatic RAA can be safely observed clinically without serial arteriograms and without fear of rupture. Most solitary saccular aneurysms can be tangentially excised followed by primary repair, a patch, or a bypass. Multiple or complex hilar aneurysms may require ex vivo technique.

    Original languageEnglish (US)
    Pages (from-to)26-34
    Number of pages9
    JournalJournal of Vascular Surgery
    Volume9
    Issue number1
    DOIs
    StatePublished - Jan 1 1989

    Fingerprint

    Renal Artery
    Aneurysm
    Rupture
    Hypertension
    Therapeutics
    Kidney
    Renovascular Hypertension
    Flank Pain
    Nephrectomy
    Fear

    All Science Journal Classification (ASJC) codes

    • Surgery
    • Cardiology and Cardiovascular Medicine

    Cite this

    Martin, R. S., Meacham, P. W., Ditesheim, J. A., Mulherin, J. L., & Edwards, W. (1989). Renal artery aneurysm: Selective treatment for hypertension and prevention of rupture. Journal of Vascular Surgery, 9(1), 26-34. https://doi.org/10.1016/0741-5214(89)90216-4

    Renal artery aneurysm : Selective treatment for hypertension and prevention of rupture. / Martin, Raymond S.; Meacham, Patrick W.; Ditesheim, Jeff A.; Mulherin, Joseph L.; Edwards, William.

    In: Journal of Vascular Surgery, Vol. 9, No. 1, 01.01.1989, p. 26-34.

    Research output: Contribution to journalArticle

    Martin, RS, Meacham, PW, Ditesheim, JA, Mulherin, JL & Edwards, W 1989, 'Renal artery aneurysm: Selective treatment for hypertension and prevention of rupture', Journal of Vascular Surgery, vol. 9, no. 1, pp. 26-34. https://doi.org/10.1016/0741-5214(89)90216-4
    Martin, Raymond S. ; Meacham, Patrick W. ; Ditesheim, Jeff A. ; Mulherin, Joseph L. ; Edwards, William. / Renal artery aneurysm : Selective treatment for hypertension and prevention of rupture. In: Journal of Vascular Surgery. 1989 ; Vol. 9, No. 1. pp. 26-34.
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