Solitary renal artery aneurysm.

The records of all patients with solitary renal artery aneurysms seen between January 1968 and December 1978 were reviewed. Patients with fibromuscular dysplasia were excluded from analysis. Of the 67 patients seen, 34 had the diagnosis made on the basis of arteriography, 31 on the basis of abdominal roentgenography, and 2 at surgery. The ages of the 67 patients (34 men and 33 women) ranged from 21 to 90 years, with a mean of 61 years. Only five patients (8%) were symptomatic; all five presented with abdominal pain. Forty-six patients (69%) had associated hypertension. Five patients underwent surgical repair when initially seen. Only one patient had preoperative abdominal pain that was considered to be related to the aneurysm. The aneurysm sizes ranged from 0.3 to 4.0 cm, with a mean of 1.5 cm. In 45 patients (67%) the aneurysm was calcified. Follow-up ranged from 1 to 17 years, with a mean 5.7 and a median of 8.0 years. During follow-up, all aneurysms remained clinically silent. No aneurysms were subsequently repaired, no new cases of hypertension developed, no nephrectomies had to be performed, and no ruptures occurred. Eight patients (12%) died; no death was related to a complication of the aneurysm. This study supports the view that patients with asymptomatic solitary saccular renal artery aneurysm may be safely observed without surgical intervention.