Incidence of Renal Artery Pseudoaneurysm Following Open and Minimally Invasive Partial Nephrectomy: A Systematic Review and Comparative Analysis

Renal artery pseudoaneurysm is a rare but life-threatening condition. Its incidence is higher after minimally invasive partial nephrectomy (PN) than after the open approach. We reported a case of a renal artery pseudoaneurysm occurred about four months after a clampless laparoscopic PN. A 49-year-old female underwent a clampless laparoscopic PN for a right renal tumor with high surgical complexity. The patient experienced an intraoperative blood loss from renal bed and the surgeons performed a deep medullary absorbable suture. Three months after surgery the patient underwent a renal ultrasonography with good results. The patient came to our emergency department 115 days after surgery with a hypovolemic shock stage 3. Her CT scan showed a pseudoaneurysm of a lower pole vessel of the right kidney. She underwent a superselective embolization of the segmental renal artery. The surgical complexity of the tumor, the anatomical relationships with the renal sinus and the deep medullary suture could be responsible for the development of the pseudoaneurysm. The authors presented an unusual case of a very late detected pseudoaneurysm of a renal vessel, suggesting that all very complex renal tumors removed with a minimally invasive technique should be followed up closely at least during the first six-months in order to early detect this major complication.

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Natural history of asymptomatic renal artery pseudoaneurysm after robot-assisted partial nephrectomy

Translational Andrology and Urology ◽

10.21037/tau-21-384 ◽

2021 ◽

Vol 10 (9) ◽

pp. 3555-3565

Author(s):

Tatsuya Takayama ◽

Akifumi Fujita ◽

Toru Sugihara ◽

Akira Fujisaki ◽

Masahiro Yamazaki ◽

...

Keyword(s):

Natural History ◽

Renal Artery ◽

Partial Nephrectomy ◽

Robot Assisted ◽

Artery Pseudoaneurysm ◽

History Of ◽

Renal Artery Pseudoaneurysm

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Renal artery pseudoaneurysm after open partial nephrectomy for renal cell carcinoma

Urologia Journal ◽

10.1177/0391560319862250 ◽

2019 ◽

Vol 87 (1) ◽

pp. 11-14

Author(s):

Erdem Kisa ◽

Gokhan Koc ◽

Cem Yucel ◽

Mehmet Zeynel Keskin ◽

Ahmet Ergin Capar ◽

...

Keyword(s):

Renal Artery ◽

Partial Nephrectomy ◽

Macroscopic Hematuria ◽

Artery Pseudoaneurysm ◽

Open Partial Nephrectomy ◽

Delayed Bleeding ◽

Patient Morbidity ◽

Renal Artery Pseudoaneurysm ◽

Renal Artery Embolization ◽

Computer Tomography Angiography

Introduction: Renal artery pseudoaneurysm is a well-described complication of open and laparoscopic partial nephrectomy. Delayed bleeding from a renal artery pseudoaneurysm is rare after open partial nephrectomy. Case description: Here, we present a 75-year-old man who, 14 days after undergoing an open right partial nephrectomy for an endophytic 4.5 cm tumor, developed painless macroscopic hematuria. Prompt computer tomography angiography imaging, followed by therapeutic angio-embolization of segmental renal artery with coils, treated the pseudoaneurysm successfully. Conclusion: Renal artery pseudoaneurysm can be treated rapidly, effectively, and with minimal patient morbidity via percutaneous renal artery embolization.

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