Is endovascular main renal artery embolization with kidney sacrifice a safe option? A case report of renal artery aneurysm

Treatment of renal artery aneurysm has traditionally been performed with conventional vascular reconstructive surgical repair. Endovascular treatment of renal artery aneurysm has been well described; however, embolization of the entire renal artery with subsequent infarction of the kidney has been infrequently reported. We are presenting a case of a 65-year-old man with marked retro-peritoneal lymphadenopathy secondary to lymphoma. He was found incidentally to have 3.9 cm × 3.9 cm left main renal artery aneurysm which was not amenable to endovascular stent-grafting and an open surgical repair carried high risk. He was treated with endovascular embolization of the entire left renal artery with subsequent infarction of left kidney; this was tolerated well by the patient who made good recovery with moderate elevation of the serum creatinine. This case illustrates that renal artery embolization is a safe option to treat renal artery aneurysm when conventional repair is problematic and other means of endovascular repair are not possible.