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Southern Association For Vascular Surgery

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Open Surgical Repair of a Right Renal Artery Aneurysm
Scott T. Robinson, Matthew A. Corriere
University of Michigan, Ann Arbor, MI

OBJECTIVES: Renal artery aneurysms are a rare clinical entity, with an incidence of less than 0.1%. Although rupture of renal artery aneurysms is rare, it is associated with a 10% mortality rate. Therefore, a repair is typically offered to patients with aneurysms greater than 3 cm, symptomatic patients, or in women of child bearing age. Treatment options vary but are typically dependent on aneurysm morphology and patient risk factors. METHODS: A 61-year-old female was seen in clinic with an incidental finding of a 3.5 cm right renal artery aneurysm noted on a CT scan. Angiography was performed, and the anatomy was deemed to be unsuitable for endovascular repair. After preoperative risk stratification, the patient was offered an elective open repair. RESULTS: The patient underwent open repair of the renal artery aneurysm via a right subcostal incision. A large, calcified saccular aneurysm was divided, and the inflow and outflow branches were brought together and reapproximated in a primary repair. Intraoperative duplex confirmed an adequate technical endpoint. CONCLUSIONS: Open operative treatment of renal artery aneurysms is performed infrequently. Here we present successful management of a large right renal artery aneurysm. We demonstrate reconstruction of the renal artery through reapproximating the two ends of the aneurysm sack containing the inflow and outflow branches.


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