gms | German Medical Science

Background: Improvement of diagnosis and surgical treatment of segmental renal artery aneurysms ex vivo.

Methods: The results of clinical examination, laboratory, instrumental, intraoperative observations were analyzed in 10 patients with 11 ex vivo reconstructions of segmental renal artery aneurysms, which were observed at the Vascular surgery department of Lviv Regional Clinical Hospital for the period from 2006 to 2020.

Results: In our observations, in 10 patients, by clinical examination and diagnostic imaging (CT, MRI angiography) the diagnosis of renal artery aneurysms with different branching was confirmed. Presence of drug-resistant arterial hypertension, functionally significant renal artery stenosis, hematuria with aneurysm size >1.0 cm in diameter have become direct indications for surgical intervention – extracorporeal renal artery aneurysm resection with kidney autotransplantation. Successful results were obtained in 8 patients. Among postoperative complications were observed: thrombosis of renal vessels – in one patient, for which a nephrectomy was performed, insignificant renal failure with subsequent regression – in one case. The clinical course of the postoperative period in other patients – without complications. The normalization of blood pressure was achieved, at the control ultrasound examination magistral blood flow through renal arteries and their intrarenal branches is determined.

Conclusion: Extracorporeal resection of renal artery aneurysms in conditions of pharmaco-cold ischemia without ureter ligation with subsequent orthotopic kidney autotransplantation is the efficient method of treatment, that provides satisfactory long-term clinical results and is performed in cases when classical reconstruction or endovascular correction are impossible.