Reconstruction of renal artery aneurysms. Vessel morphology and clinical results

OBJECTIVE: To analyse retrospectively from case notes and follow-up examinations the effectiveness of vascular surgery for renal artery aneurysm (RAA). PATIENTS AND METHODS: Operations for uni- or bilateral RAA were performed, between January 1978 and December 1996, on 61 patients (39 women, 22 men; mean age 47.4 years), 81% with arterial hypertension. Extracorporeal reconstruction with renal autotransplantation was performed in 4 of the patients. Clinical examination and duplex sonography or angiography were performed a mean of 58.4 months postoperatively. RESULTS: Postoperative morbidity rate related to the surgery was 13%; there were no early postoperative death. At the time of follow-up 80% of the reconstructed renal arteries were patent. 26% of hypertensive were cured of the hypertension, while the blood pressure was significantly reduced in 40%. CONCLUSIONS: Vascular reconstruction of RAA can be effective so that primary nephrectomy is no longer indicated. Reconstruction in situ can usually be successfully performed, reducing operative time and reducing surgical trauma. The operation is indicated in any RAA of greater than 2 cm diameter, in all patients with hypertension and renal artery stenosis, and also for smaller aneurysms in patients in good general health and in women of child-bearing age.