Long-Term Outcome of Single Institutional Experience with Conservative and Surgical Management for Renal Artery Aneurysm

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Background: Spontaneous rupture risk in renal artery aneurysm (RAA) is extremely low. Indication criteria for surgical repair of RAA remain uncertain. Objective: Long-term outcomes of conservative therapy and surgical repair were evaluated. Patients: The study included fifty-eight patients (17 male, 41 female) diagnosed with RAA during the last 21 years. Median age at the time of diagnosis was 62 (19-85) years old, and the median follow-up period was 69 (3-216) months. Methods: The patients were divided into two groups; conservative group (n = 30) who had been followed up with blood pressure control, and treatment group (n = 29), who underwent intervention. Results: Multiple efferent aneurysmal branches were found in seven conservative cases and 16 treatment cases (P = 0.002). The median maximum diameter of aneurysm was lower in conservative group than in the treatment group (15 versus 25 mm, P = 0.005). Two cases in conservative group showed increase in aneurysm size during follow-up. Hypertensive state had been essentially no change in both groups during follow-up. Renal function decreased with age similarly both in conservative and treatment groups. Conclusions: Our conservative management criteria for RAA are justifiable and even too strict. More loose criteria will be pursued in conservative group selection.