- Incidence
- Rare; incidence < 0.1%
- F >M
- Aetiology
- Idiopathic; Association with HT
- Medial fibrodysplasia
- Arteritis-related microaneurysms
- Clinical
- Most asymptomatic
- Renovascular HT may occur in 30%
- Spontaneous rupture is rare, except during pregnancy
- Bleeding may tamponade in Gerota’s fascia
- Pathology
- Saccular aneurysm located at primary or secondary bifurcation of the renal arteries
- Emboli rarely occur
- Investigations
- Management
- Small aneurysms may be managed conservatively – BP control & F/U
- Operation indicated:
- Women of childbearing age / anticipation of pregnancy
- Uncontrolled HT, from secondary renal ischemia
- Aneurysm coincident with significant stenosis
- Aneurysms containing thrombus with evidence of distal embolization
- Dissecting aneurysms
- Symptomatic aneurysms – associated with pain or haematuria
- ? Large aneurysms
- Nephrectomy is recommended for rupture