Intrarenal pseudoaneurysms (IRP) are unfrequent diseases; the main difference with a true aneurysm is that this one is made of all the three histological layers of the arterial wall, on the other hand a pseudoaneurysm contains just some, more often one or none, of these layers. IRPs are generally caused by trauma or iatrogenic procedures; the most common iatrogenic cause is percutaneous renal biopsy. The ruptured IRPs usually present with massive hematuria occurring within days or a few weeks after the trauma and are associated with back pain. Color-Doppler sonography is the first level exam to attend for evaluating the patient; then a contrast enhanced CT scan is suggested to better evaluate the vascular system and the lesion itself. Angiography is useful for diagnosis and treatment at the same time; because of this surgery should be considered as a second line approach. In certain situations, especially when the patient is asymptomatic and the pseudoaneurysm diameter is <2 cm, observation can be considered with CT scan follow-up. We present the case of a 32-year-old man with diagnosis of intrarenal polar artery pseudoaneurysm, occurring short after a martial art trauma and treated with a covered stent-graft.
Renal artery post-traumatic embolization with stent graft
Faiella E;Beomonte Zobel B
2012-01-01
Abstract
Intrarenal pseudoaneurysms (IRP) are unfrequent diseases; the main difference with a true aneurysm is that this one is made of all the three histological layers of the arterial wall, on the other hand a pseudoaneurysm contains just some, more often one or none, of these layers. IRPs are generally caused by trauma or iatrogenic procedures; the most common iatrogenic cause is percutaneous renal biopsy. The ruptured IRPs usually present with massive hematuria occurring within days or a few weeks after the trauma and are associated with back pain. Color-Doppler sonography is the first level exam to attend for evaluating the patient; then a contrast enhanced CT scan is suggested to better evaluate the vascular system and the lesion itself. Angiography is useful for diagnosis and treatment at the same time; because of this surgery should be considered as a second line approach. In certain situations, especially when the patient is asymptomatic and the pseudoaneurysm diameter is <2 cm, observation can be considered with CT scan follow-up. We present the case of a 32-year-old man with diagnosis of intrarenal polar artery pseudoaneurysm, occurring short after a martial art trauma and treated with a covered stent-graft.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.