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ITALIAN JOURNAL OF VASCULAR AND ENDOVASCULAR SURGERY
Rivista di Chirurgia Vascolare ed Endovascolare
Italian Journal of Vascular and Endovascular Surgery 2012 June;19(2):113-6
Renal artery post-traumatic embolization with stent graft
Grasso R. F., Giurazza F., Faiella E., Luppi G., Del Vescovo R., Cazzato L. R., Zobel B. B.
Radiology Department, Campus Bio-Medico University, Rome, Italy
Intrarenal pseudoaneurysms (IRP) are unfrequent diseases; the main difference with a true aneurysm is that this one is made of all the three histological layers of the arterial wall, on the other hand a pseudoaneurysm contains just some, more often one or none, of these layers. IRPs are generally caused by trauma or iatrogenic procedures; the most common iatrogenic cause is percutaneous renal biopsy. The ruptured IRPs usually present with massive hematuria occurring within days or a few weeks after the trauma and are associated with back pain. Color-Doppler sonography is the first level exam to attend for evaluating the patient; then a contrast enhanced CT scan is suggested to better evaluate the vascular system and the lesion itself. Angiography is useful for diagnosis and treatment at the same time; because of this surgery should be considered as a second line approach. In certain situations, especially when the patient is asymptomatic and the pseudoaneurysm diameter is <2 cm, observation can be considered with CT scan follow-up. We present the case of a 32-year-old man with diagnosis of intrarenal polar artery pseudoaneurysm, occurring short after a martial art trauma and treated with a covered stent-graft.