Natural History of Renal Artery Aneurysm Elucidated by Repeated Angiography and Pathoanatomical Studies

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Abstract
The findings from repeated angiographies in 16 female and 5 male patients with altogether 34 renal artery aneurysms were studied. The mean interval between the 1st and last angiography was 35 mo. Seven patients had multiple aneurysms; 2-4 angiographies were performed in each patient. They showed no change in 28 aneurysms and slight or minimal enlargement, thrombosis or calcification in the other 6. The clinical course was uneventful except for severe hypertension in 3 patients. No rupture occurred. Eight patients, 5 of whom had solitary, saccular aneurysms, were operated upon. Pathoanatomically, fibromuscular dysplasia or secondarily changed fibromuscular dysplasia was found in 7 of them. Four died of unrelated disease having been followed up for 55-204 mo. (mean 102 mo.). None were alive and symptomless at the end of follow-up 11-195 mo. (mean 97 mo.) after the 1st angiography. The risk of rupture of a renal artery aneurysm is evidently very small. Fibromuscular dysplasia is evidently common even when the angiography shows solitary, saccular aneurysm only.

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