In March 2nd of 2017, 59 y/o patient N.G. was admitted to MC Erebouni with macrohematuria (presence blood in urine).
In 18.01.2017 a patient was carried out a resection of the left upper renal lobe for renal cell cancer. He was discharged in successful condition. However, 1.5 month later a patient noticed a blood in the urine (macrohematuria), which has become abundant for the last week.
CT scan with intravenous contrasting has reveal the aneurysm of the additional left renal artery (which was the cause of blooding).
There are 2 methods of the treatment of additional renal artery aneurysm: open surgical and endovascular.
It was decided to carry out endovascular occlusion of the left additional renal artery from which the aneurysm was feeding.
In March the 3rd of 2017 the patient N.G. under general anesthesia underwent to the intervention catheterization for aneurism coil occlusion: through right femoral artery access (the left common iliac artery was made a prosthetic appliance 10 years ago) by intervention cardiologist of Department of Angiography and Intervention cardiology A. Tsaturyan was carried out selective angiography of the left renal arteries that confirmed the diagnosis, which was established by CT exam. With the help of intravascular COOK Coils (USA) the embolization of additional renal artery aneurysm was carried out. Total embolization was reached by three Coils, after which anterograde flow wasn`t observed. Blood in the urine (hematuria) was no longer observed and he was discharged on the second day.
Renal artery aneurysm is a rare pathology, which is found in 0.09% cases, diagnosed by CT exam, which is prescribing, as a rule, in renovascular hypertension, hematuria. Open surgical intervention has risks related to both common anesthesia and surgery. Endovascular, minimally invasive treatment of aneurysms and renal arterio-venous fistula gives 100% guaranteed solution for this pathology. This creates an opportunity to avoid resection and even kidney removal, there is a low intraoperative risk and short period of hospitalization, combined with high efficiency of intervention.
Such kind of surgery - embolization of additional renal artery aneurysm and arterio-venous fistula was carried out in Armenia, in MC Erebouni for the first time.