Embolization of Multiple Cerebral Aneurysms in a Patient With Autosomal Dominant Polycystic Kidney Disease Post-Renal Transplantation.

Abstract

Intracranial aneurysms in patients with autosomal dominant polycystic kidney disease (ADPKD) are relatively rare but pose significant challenges due to the increased risk of rupture and the impact of renal transplantation and immunosuppressive therapy. This article reports the case of a 54-year-old female with ADPKD who, following renal transplantation, presented with a subarachnoid hemorrhage (SAH). Brain imaging revealed multiple intracranial aneurysms, including 1 at the A3 segment of the left anterior cerebral artery (4.2 mm × 3.2 mm), 1 at the origin of the left posterior cerebral artery (4.1 mm × 4.9 mm), and 1 at the C7 segment of the left internal carotid artery (4.3 mm × 2.7 mm). Endovascular embolization was performed to treat the high-risk aneurysms, with careful management of the risk of contrast-induced nephropathy. Renal function remained stable post-procedure. At 9 months of follow-up, the patient was living independently. This case highlights the feasibility and safety of endovascular embolization for managing intracranial aneurysms in ADPKD patients following renal transplantation.