الفهرس 
IntroductionOnly 14 pages are availabe for public view
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Abstract
Endovascular management of RAA has become the management of choice even with complex anatomy as an effective minimally invasive maneuverans as an alternative to surgery for the management of symptomatic and asymptomatic renal artery aneurysms (RAAs). The aim of this work is to evaluate the role of trans-catheter procedures in the management of renal artery aneurysms (including control of symptoms). This study was carried out at the Interventional Radiology Unit, Radiology Department, Urology and Nephrology Center, Mansoura University, Mansoura, Egypt throughout the period from April, 2022 to June, 2023. Our prospective minimally invasive study included 30 patients with RAAs (18 males, 12 females) aged from 6 to 67 years old. They underwent 30 arteriographies, managed by trans catheter procedures (especially selective embolization with coils) as an elective procedure for symptomatic patients or as an urgent management in emergency situations. All patients undergo follow-up by clinical assessment, medical imaging and laboratory investigations. All patients were subjected to the following: A) Full History Taking B) Clinical Examination Included: C) Laboratory investigations: D) Radiological Imaging: Different imaging modalities were used for the diagnosis of RAA & preembolization planning as the following: • Abdominal US. • NCCT scan. • CECT scan and CTA for renal vessels. • Gadolinium-enhanced MRA. • Diagnostic catheter angiography selective Arterial Embolization: • 30 patients were managed by SAE. They underwent 30 arteriographies. • Good patient preparation with proper choice of anesthesia. • Toshiba (CAT-805B) machine and Digital subtraction angiography (DSA) techniques were utilized in all cases. • Embolic materials were used including; microcoils only or combined with microspheres. • All patients undergo follow-up by clinical assessment, medical imaging and laboratory investigations. Our current study revealed: • A high overall success rate is (93.3%). • A high technical success rate is (96. 7%). • A high clinical success rate (92.8% of patients presented with gross hematuria showed stoppage of hematuria post-embolization (also (95.8 %) of patients presented with flank pain show relieving of pain after embolization. (P= <0.001). • Low rates of re-embolization (6.7%) and recurrence (3.3%). • Low complication rates; major complications (3.3%) and minor complications (23.3%). • No significant changes in serum creatinine levels and haemoglobin before and after SAE on follow-up visits. In conclusion, endovascular management is an effective minimally invasive and safe procedure in the management of RAAs either in elective or urgent medical situations with preservation of renal functions and low minor and major complication. Recommendations: 1. Increase the number of studied groups. 2. Assure that pre-arteriography images of all patients are obtained from same hospital with same equipments. 3. Good patient preparation before embolization. 4. The use of superselective technique in embolization is mandatory to reduce the risk of ischemia induced hypertension and related renal impairment. 5. Increase the duration of follow-up period.