To identify the pattern of growth of true renal artery aneurysms (RAA) in a multicentre cohort and to propose an algorithm for the follow-up of asymptomatic RAA.

Methods

A retrospective review of all patients identified to have true RAA with subsequent follow-up cross-sectional imaging at three centres over a 15-year period was performed. Aneurysm maximal diameter was measured on initial and latest imaging and growth pattern assessed by two radiologists in consensus.

Results

In total, 155 patients with 171 aneurysms were identified with follow-up imaging. Mean initial aneurysm size was 1.27 cm (range 0.3–3.4 cm) with a mean follow-up time of 61.08 months (range 12–182.5 months). 159 (93%) aneurysms remained stable in size over time. Overall mean growth rate was 0.015 cm/y. RAA ≤ 1.5 cm at diagnosis were associated with significantly lower mean growth rates (0.01 cm/year; p = 0.0059). No RAA rupture occurred during the follow-up period.

Conclusion

The present study demonstrates an indolent course of RAA with no ruptures reported and stability over time demonstrated in 93% of a multicentre cohort. These findings are in agreement with multiple other published studies. A positive impact on cost, equity of resources, and cumulative radiation exposure with rationalisation of RAA surveillance warrants its consideration, particularly in low risk cohorts.

Conflicts of Interest

The authors declare no conflicts of interest.

Open Research

Data Availability Statement

The data that support the findings of this study are available from the corresponding author upon reasonable request.

References

1J. Gonzalez, M. Esteban, G. Andres, E. Linares, and J. I. Martinez-Salamanca, “Renal Artery Aneurysms,” Current Urology Reports 15, no. 1 (2014): 376, https://doi.org/10.1007/s11934-013-0376-z.
10.1007/s11934-013-0376-z
CAS PubMed Google Scholar
2R. A. Chaer, C. J. Abularrage, D. M. Coleman, et al., “The Society for Vascular Surgery Clinical Practice Guidelines on the Management of Visceral Aneurysms,” Journal of Vascular Surgery 72, no. 1S (2020): 3S–39S, https://doi.org/10.1016/j.jvs.2020.01.039.
10.1016/j.jvs.2020.01.039
PubMed Web of Science® Google Scholar
3J. Zhang, K. Harish, G. Speranza, et al., “Natural History of Renal Artery Aneurysms,” Journal of Vascular Surgery 77, no. 4 (2023): 1199–1205, https://doi.org/10.1016/j.jvs.2022.11.010.
10.1016/j.jvs.2022.11.010
PubMed Web of Science® Google Scholar
4C. Henriksson, P. Lukes, A. E. Nilson, and S. Pettersson, “Angiographically Discovered, Non-Operated Renal Artery Aneurysms,” Scandinavian Journal of Urology and Nephrology 18, no. 1 (1984): 59–62, https://doi.org/10.3109/00365598409182164.
10.3109/00365598409182164
CAS PubMed Web of Science® Google Scholar
5M. Rossi, M. Krokidis, E. Kashef, B. Peynircioglu, and M. A. Tipaldi, “CIRSE Standards of Practice for the Endovascular Treatment of Visceral and Renal Artery Aneurysms and Pseudoaneurysms,” Cardiovascular and Interventional Radiology 47, no. 1 (2024): 26–35, https://doi.org/10.1007/s00270-023-03620-w.
10.1007/s00270-023-03620-w
PubMed Web of Science® Google Scholar
6R. S. Martin, 3rd, P. W. Meacham, J. A. Ditesheim, J. L. Mulherin, Jr., and W. H. Edwards, “Renal Artery Aneurysm: Selective Treatment for Hypertension and Prevention of Rupture,” Journal of Vascular Surgery 9, no. 1 (1989): 26–34.
10.1016/0741-5214(89)90216-4
PubMed Web of Science® Google Scholar
7T. Pfeiffer, L. Reiher, K. Grabitz, et al., “Reconstruction for Renal Artery Aneurysm: Operative Techniques and Long-Term Results,” Journal of Vascular Surgery 37, no. 2 (2003): 293–300, https://doi.org/10.1067/mva.2003.117.
10.1067/mva.2003.117
PubMed Web of Science® Google Scholar
8J. R. Cohen and F. S. Shamash, “Ruptured Renal Artery Aneurysms During Pregnancy,” Journal of Vascular Surgery 6, no. 1 (1987): 51–59, https://doi.org/10.1067/mva.1987.avs0060051.
10.1067/mva.1987.avs0060051
CAS PubMed Web of Science® Google Scholar
9K. B. Soliman, Y. Shawky, M. M. Abbas, M. Ammary, and A. Shaaban, “Ruptured Renal Artery Aneurysm During Pregnancy, a Clinical Dilemma,” BMC Urology 6, no. 22 (2006): 22, https://doi.org/10.1186/1471–2490-6-22.
10.1186/1471-2490-6-22
PubMed Google Scholar
10D. M. Coleman and J. C. Stanley, “Renal Artery Aneurysms,” Journal of Vascular Surgery 62, no. 3 (2015): 779–785, https://doi.org/10.1016/j.jvs.2015.05.034.
10.1016/j.jvs.2015.05.034
PubMed Web of Science® Google Scholar
11J. C. Stanley, E. L. Rhodes, B. L. Gewertz, C. Y. Chang, J. F. Walter, and W. J. Fry, “Renal Artery Aneurysms. Significance of Macroaneurysms Exclusive of Dissections and Fibrodysplastic Mural Dilations,” Archives of Surgery 110, no. 11 (1975): 1327–1333, https://doi.org/10.1001/archsurg.1975.01360170067009.
10.1001/archsurg.1975.01360170067009
CAS PubMed Web of Science® Google Scholar
12W. P. Robinson, 3rd, R. Bafford, M. Belkin, and M. T. Menard, “Favorable Outcomes With In Situ Techniques for Surgical Repair of Complex Renal Artery Aneurysms,” Journal of Vascular Surgery 53, no. 3 (2011): 684–691, https://doi.org/10.1016/j.jvs.2010.10.050.
10.1016/j.jvs.2010.10.050
PubMed Web of Science® Google Scholar
13A. J. Brownstein, Y. Erben, S. Rajaee, et al., “Natural History and Management of Renal Artery Aneurysms in a Single Tertiary Referral Center,” Journal of Vascular Surgery 68, no. 1 (2018): 137–144, https://doi.org/10.1016/j.jvs.2017.10.086.
10.1016/j.jvs.2017.10.086
PubMed Web of Science® Google Scholar
14J. Q. Klausner, M. P. Harlander-Locke, A. N. Plotnik, E. Lehrman, B. G. DeRubertis, and P. F. Lawrence, “Current Treatment of Renal Artery Aneurysms May Be Too Aggressive,” Journal of Vascular Surgery 59, no. 5 (2014): 1356–1361, https://doi.org/10.1016/j.jvs.2013.11.062.
10.1016/j.jvs.2013.11.062
PubMed Web of Science® Google Scholar
15J. Q. Klausner, P. F. Lawrence, M. P. Harlander-Locke, et al., “The Contemporary Management of Renal Artery Aneurysms,” Journal of Vascular Surgery 61, no. 4 (2015): 978–984, https://doi.org/10.1016/j.jvs.2014.10.107.
10.1016/j.jvs.2014.10.107
PubMed Web of Science® Google Scholar
16E. J. Wayne, M. S. Edwards, J. M. Stafford, K. J. Hansen, and M. A. Corriere, “Anatomic Characteristics and Natural History of Renal Artery Aneurysms During Longitudinal Imaging Surveillance,” Journal of Vascular Surgery 60, no. 2 (2014): 448–452, https://doi.org/10.1016/j.jvs.2014.03.006.
10.1016/j.jvs.2014.03.006
PubMed Web of Science® Google Scholar
17M. Umetsu, H. Goto, M. Ohara, et al., “Natural History and Chronological Growth Rate of Renal Artery Aneurysms,” Annals of Vascular Diseases 10, no. 4 (2017): 411–416, https://doi.org/10.3400/avd.oa.17–00075.
10.3400/avd.oa.17-00075
PubMed Google Scholar
18T. K. M. Wang and M. Y. Desai, “Optimal Surveillance and Treatment of Renal and Splenic Artery Aneurysms,” Cleveland Clinic Journal of Medicine 87, no. 12 (2020): 755–758, https://doi.org/10.3949/ccjm.87a.19140–2.
10.3949/ccjm.87a.19140-2
PubMed Web of Science® Google Scholar
19P. De Rango, “Aneurysm Diameter Measurement: A Challenging and Frustrating Task,” European Journal of Vascular and Endovascular Surgery 43, no. 1 (2012): 34, https://doi.org/10.1016/j.ejvs.2011.10.004.
10.1016/j.ejvs.2011.10.004
CAS PubMed Web of Science® Google Scholar
20N. Grondal, M. B. Bramsen, M. D. Thomsen, C. B. Rasmussen, and J. S. Lindholt, “The Cardiac Cycle Is a Major Contributor to Variability in Size Measurements of Abdominal Aortic Aneurysms by Ultrasound,” European Journal of Vascular and Endovascular Surgery 43, no. 1 (2012): 30–33, https://doi.org/10.1016/j.ejvs.2011.09.025.
10.1016/j.ejvs.2011.09.025
CAS PubMed Web of Science® Google Scholar

Volume69, Issue4

June 2025

Pages 462-467

Natural History of True Renal Artery Aneurysms: A Multi-Centre Retrospective Cohort Study and Proposed Algorithm for Follow-Up

ABSTRACT

Aim

Methods

Results

Conclusion

Conflicts of Interest

Open Research

Data Availability Statement

References

References

Information

About Wiley Online Library

Help & Support

Opportunities

Connect with Wiley

Natural History of True Renal Artery Aneurysms: A Multi-Centre Retrospective Cohort Study and Proposed Algorithm for Follow-Up

ABSTRACT

Aim

Methods

Results

Conclusion

Conflicts of Interest

Open Research

Data Availability Statement

References

References

Related

Information