Operative Repair of Enlarging Hilar Renal Artery Aneurysm

Abstract

Repair of distal renal artery aneurysms poses a significant threat to kidney salvage despite improved operative techniques described over the past decades. The authors describe the case of a seventy-one-year-old woman who presented with an enlarging right renal artery aneurysm located at the renal hilum involving the lobar arteries. Operative repair was accomplished by excision of the saccular posterior wall and reconstruction with a saphenous vein patch. The ischemia time was thirty-three minutes and her postoperative course was uneventful. She was discharged home on the fifth postoperative day with normal renal function, and the renal arteriogram demonstrated a technically successful operation. They review the current literature, and this case is put into perspective with the natural history, clinical course, and present treatment of renal artery aneurysms.