Division of Vascular Surgery, Department of Surgery, College of Medicine, King Saud University, Riyadh, Saudi Arabia.
Medicine (Baltimore). 2023 Jul 7;102(27):e34216. doi: 10.1097/MD.0000000000034216.
The autosomal dominant condition known as neurofibromatosis type 1 (NF-1) is characterized by café au lait macules and neurofibromatosis. Aneurysms in renal arteries are rare. Renal artery aneurysm (RAA) can be successfully treated with endovascular procedures; however, successful cases in NF-1 adults have not been reported.
Here, we report the case of a 30-year-old female suffering from NF-1. The patient presented to the emergency department with complaints of chronic, poorly controlled hypertension. A left RAA was found om the computed tomography angiography (CTA).
A left renal artery aneurysm was diagnosed using CTA during workup for secondary hypertension.
Selective angiographym of the left renal artery confirmed a fusiform aneurysm of the distal renal artery. A self-expandable covered stent was placed, and a completion angiogram demonstrated good aneurysm sealing and contrast flow to the left kidney.
The patient's blood pressure improved after the procedure. Her medications were lowered to almost half of their baseline doses, and hydralazine was discontinued. On the follow-up visit after 4 months, the patient reported his home-measured systolic blood pressure to be less than 120 mm Hg. A repeated CTA of the abdomen showed post-left RAA repair with a covered stent and interval improvement of the left kidney.
RAA caused by NF-1 are manageable and feasible with endovascular intervention.
常染色体显性遗传疾病神经纤维瘤病 1 型（NF-1）的特征是咖啡牛奶斑和神经纤维瘤。肾动脉动脉瘤较为罕见。肾动脉动脉瘤（RAA）可以通过血管内治疗成功治疗；然而，在 NF-1 成年患者中尚未有成功的报道。
我们报告了一例 30 岁女性 NF-1 患者。该患者因慢性、难以控制的高血压就诊于急诊科。计算机断层血管造影（CTA）发现左 RAA。
在继发性高血压的检查中，CTA 诊断为左肾动脉动脉瘤。
左肾动脉选择性血管造影证实为远端肾动脉梭形动脉瘤。放置了自膨式覆膜支架，完成血管造影显示动脉瘤完全封闭，左肾显影良好。
手术后患者血压改善。她的药物剂量降低到基线剂量的一半以下，停用了肼屈嗪。4 个月后的随访中，患者报告其家庭自测收缩压低于 120mmHg。腹部重复 CTA 显示左 RAA 修复后用覆膜支架，左肾功能改善。
NF-1 引起的 RAA 可以通过血管内介入治疗进行管理和治疗。
