Case Report of Endovascular Treatment of Renal Artery Pseudoaneurysm

Arterial embolization has emerged as an effective and minimally invasive alternative for the treatment of renal pseudoaneurysms, thus avoiding the need for open surgery in many cases (Roman et al., 2017). This case report aims to discuss the presentation, diagnosis, and successful treatment of a renal artery pseudoaneurysm using arterial embolization as a therapeutic approach. P. T. G., a 51-year-old, presented with macroscopic hematuria after undergoing percutaneous nephrolithotomy (PCNL) procedure on the left kidney. Subsequent evaluation included an angio CT revealing the presence of a pseudoaneurysm in the medial region of the left kidney (Fig. 1). Given the potential severity of these vascular formations and the risks associated with a rupture (Darbyshire et al., 2014), immediate treatment was chosen. Endovascular embolization with coils was performed to treat the pseudoaneurysm. This procedure was carried out at Dom Orione Hospital, in the north of Brazil. The treatment was successful, resulting in the cessation of macroscopic hematuria the following day. Surprisingly, one year after the first episode, the patient required another PCNL, this time on the right kidney. Again, he presented with postoperative macroscopic hematuria. A new angio CT identified another renal artery pseudoaneurysm, this time on the right kidney. A second embolization was performed, and the outcome was similarly positive (Fig. 2). Despite the two episodes of renal artery pseudoaneurysms post-PCNL, there was no loss of renal function in the patient's clinical follow-up, once again highlighting the efficacy and safety of arterial embolization in this clinical context (Taylor et al., 2012). This case is an instructive example of the occurrence and management of renal artery pseudoaneurysms associated with PCNL procedures.