Wide-Neck Renal Artery Aneurysm Managed with Neuro-Retrievable Stent-Assisted Coil Embolization

Eshani J. Choksi, Shivam Kaushik, Venkat Tummala
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Abstract

Endovascular management of narrow-necked aneurysms has traditionally been with coil embolization; however, wide-necked aneurysms have been more difficult to treat due to risk of distal coil migration or intrusion into a parent vessel. We describe the case of a 76-year-old female who presented with a left-sided renal artery aneurysm and 11 mm aneurysm neck. Renal arteriography of the superior pole branch was performed, lower pole was stented, and a retrievable stent was placed in the inferior branch for the purpose of stent-assisted coiling. Penumbra detachable coils were deposited through the stent struts to jail them in with successful embolization of the aneurysm. Endovascular treatment of wide-neck renal artery aneurysms has the potential to be a successful treatment alternative in patients where surgical intervention is contraindicated. Additional studies should be performed to determine the versatility and extent of success in coil embolization for wide-neck aneurysms.
用神经可回收支架辅助线圈栓塞术治疗宽颈肾动脉动脉瘤
窄颈动脉瘤的血管内治疗传统上采用线圈栓塞术,但宽颈动脉瘤由于存在线圈远端移位或侵入母血管的风险而更难治疗。我们描述了一例 76 岁女性的病例,她患有左侧肾动脉瘤,瘤颈长达 11 毫米。对上极动脉分支进行了肾动脉造影,在下极动脉分支放置了支架,并在下极动脉分支放置了可回收支架,以进行支架辅助卷曲。Penumbra可拆卸线圈穿过支架支柱,成功栓塞动脉瘤。对于有手术治疗禁忌症的患者,血管内治疗宽颈肾动脉瘤有可能成为一种成功的替代治疗方法。应开展更多研究,以确定线圈栓塞治疗宽颈动脉瘤的多功能性和成功程度。
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