During conventional renal angiography, it was observed that the left renal stent was open but focal dilatation of the left renal artery, originating from the proximal part of the stent in the left renal artery, attributed to pseudoaneurysm was detected (Figure 1B; Supplementary material, Video S3). Since untreated renal pseudoaneurysms are potentially life-threatening, the decision for intervention was made. Endovascular treatment is currently accepted as the first-line management of renal pseudoaneurysm in hemodynamically stable patients, as it is highly effective, safe, and unlikely to cause any long-term renal impairment [3]. Therefore, the patient underwent endovascular treatment. The pseudoaneurysm was reached with a 0.014-inch guidewire through the left renal artery stent. Corsair Pro microcatheter (ASAHI Intecc, Aichi, Japan) was advanced into the aneurysm via a guidewire. The pseudoaneurysmatic segment was occluded using 6 coils (Tornado, Cook, Bloomington, IN, USA) sizing 8 × 15, 7 × 30, 7 × 20, 6 × 20, 5 × 10, and 5 × 8 mm (Figure 1C; Supplementary material, Video S4). After successful coil embolization, selective left renal angiography showed minimal contrast passage into the pseudoaneurysm (Supplementary material, Video S4). The patient was then discharged, and the follow-up was uneventful for 3 months. At the third month’s visit, computed tomographic angiography demonstrated that the pseudoaneurysm was obliterated, and there was no contrast in the pseudoaneurysm segment (Figure 1D).

Renal artery pseudoaneurysm is a rare vascular lesion and is usually related to blunt trauma, deceleration injury, or urological interventions such as partial nephrectomy, percutaneous nephrolithotomy, renal biopsy-ureterorenoscopy for laser lithotripsy, and renal transplantation. Although these patients are clinically asymptomatic, clinical manifestations of these lesions include macroscopic hematuria, flank and lower back pain, hypertension and palpable abdominal mass [2].

We described a pseudoaneurysm of the renal artery that developed 3 years after renal artery stenting. Continued atherosclerotic process and hypertension following renal artery stenting may have led to the development of pseudoaneurysm. The appearance of a pseudoaneurysm has not previously been reported in the literature after renal artery stenting. Consequently, it should be kept in mind that, besides percutaneous interventions and traumas to the urinary system, pseudoaneurysm may also develop after renal artery stenting.

Supplementary material

Supplementary material is available at https://journals.viamedica.pl/kardiologia_polska.

Article information

Conflict of interest: None declared.

Open access: This article is available in open access under Creative Common Attribution-Non-Commercial-No Derivatives 4.0 International (CC BY-NC-ND 4.0) license, allowing to download articles and share them with others as long as they credit the authors and the publisher, but without permission to change them in any way or use them commercially. For commercial use, please contact the journal office at kardiologiapolska@ptkardio.pl.

How to cite: Çelik M, Kültürsay B, Küp A, et al. Endovascular treatment of renal artery pseudoaneurysm arising from the previously implanted renal artery stent. Kardiol Pol. 2021; 79(12): 1391–1392, doi: 10.33963/KP.a2021.0153.

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