Complex renal artery aneurysms: liquids or coils?

Although renal aneurysms are considered uncommon lesions, they are being disclosed more often with the increasing use of noninvasive imaging diagnostic methods. As the natural history is poorly defined, criteria for treatment are still controversial. Because it is less invasive, the endovascular treatment of renal artery aneurysms has become preferable to surgery, over recent years. The development of microcatheter-guidewire systems and new embolic materials, primarily used in interventional neuroradiolgy, enables a superselective embolization, even in complex lesions. We describe our experience in 11 complex renal artery aneurysms, using platinum detachable coils, liquid embolic agents (glue and Onyx), and remodeling technique, according to the lesion architecture and topographic classification. Complete durable occlusion was obtained in all cases, with only two minor complications. If an appropriated strategy is done and the tools are available, the endovascular approach currently is the first treatment option for renal artery aneurysms.