Management of complex symptomatic renal artery aneurysm in a patient with Sjögren's syndrome and systemic lupus erythematosus.

Abstract

Renal artery aneurysms (RAAs) are usually incidental findings during investigation of other pathologies; the majority remain asymptomatic. Larger RAAs can present with haematuria, hypertension, renal function decline, distal embolisation and even rupture. In this case report, we outline our novel approach in treating a complex type III RAA of a man in his 70s, who presented with right side abdominal and flank pain with persisting haematuria. The patient underwent a successful percutaneous endovascular procedure with placement of a C-Guard stent as a flow diverting device. Our satisfactory results, with preservation of all side branches, resolution of the patient's symptomatology, improvement of blood pressure control, persisted at 12 months follow-up, along with complete exclusion of the aneurysm from the circulation. The dual-layer design of the C-Guard stent, even though initially designed for treatment of carotid artery disease, effectively stabilised the aneurysm and safeguarded the side branches while minimising complications.