A Qualitative Systematic Review of Endovascular Management of Renal Artery Aneurysms.

Autor:	Sheahan KP; Department of Radiology, Beaumont Hospital, Dublin, Ireland; Royal College of Surgeons in Ireland, Dublin, Ireland. Electronic address: kevinsheahan@rcsi.ie., Alam I; Royal College of Surgeons in Ireland, Dublin, Ireland., Pehlivan T; Royal College of Surgeons in Ireland, Dublin, Ireland., Pasqui E; Department of Medicine, Surgery and Neuroscience, University of Siena, Siena, Italy., Briody H; Department of Radiology, Beaumont Hospital, Dublin, Ireland; Royal College of Surgeons in Ireland, Dublin, Ireland., Kok HK; Northern Imaging Victoria, Northern Health, Melbourne, Australia; NECTAR Research Group, Northern Health, Melbourne, Australia; Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Melbourne, Australia., Asadi H; Interventional Neuroradiology Service, Department of Radiology, Austin Health, Heidelberg, Victoria, Australia; Interventional Neuroradiology Unit, Monash Imaging, Monash Health, Clayton, Victoria, Australia., Lee MJ; Department of Radiology, Beaumont Hospital, Dublin, Ireland; Royal College of Surgeons in Ireland, Dublin, Ireland.
Jazyk:	angličtina
Zdroj:	Journal of vascular and interventional radiology : JVIR [J Vasc Interv Radiol] 2024 Aug; Vol. 35 (8), pp. 1127-1138. Date of Electronic Publication: 2024 Apr 16.
DOI:	10.1016/j.jvir.2024.04.004
Abstrakt:	Purpose: To perform a qualitative systematic review of endovascular management of renal artery aneurysms (RAAs). Materials and Methods: A comprehensive electronic search of PubMed, MEDLINE, Embase, Google Scholar, and Cochrane databases from 2000 to 2022 was performed using the search terms "renal artery," "aneurysm," and "endovascular." Means of outcome measures were calculated with a primary end point focused on RAA-related mortality and rupture. Secondary end points included reintervention rate and renal infarction. Results: Twenty-six, single-center, retrospective, observational studies were included. There were 454 RAAs treated in 427 patients using endovascular techniques. Mean age was 53.8 years, with a female predominance (62%). A variety of endovascular treatments of RAA were used with excellent technical success (96%), renal parenchymal preservation, and a low rate of moderate/severe adverse events (AEs). Primary coil embolization was the most commonly used technique (44.7%). There was an overall AE rate of 22.9%, of which 6.7% were moderate/severe and there was 0% periprocedural mortality. The most common AE was renal infarction (49 patients, 11.5%); however, renal function was preserved in 84% of patients. Nephrectomy rate was 0.4%. Computed tomography (CT) angiography was the most common imaging follow-up modality used in 72% of studies. Only 9 studies (34%) reported anticoagulant use. Although the risk of delayed aneurysm reperfusion warrants clinical and imaging surveillance, relatively few patients (3%) required reintervention in this cohort. Conclusions: Endovascular management of RAA is a technically feasible treatment option with low rates of AEs and reintervention. The present study highlights the techniques available for interventional radiologists, a need for standardization of AE reporting, anticoagulation therapy, and follow-up imaging. (Copyright © 2024 SIR. Published by Elsevier Inc. All rights reserved.)
Databáze:	MEDLINE
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