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Renal artery aneurysm

Key sources
The following summarized guidelines for the evaluation and management of renal artery aneurysm are prepared by our editorial team based on guidelines from the Society for Vascular Surgery (SVS 2020).
1

Guidelines

1.Diagnostic investigations

Diagnostic imaging: obtain CTA as first-line imaging in patients with suspected RAA.
B
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  • Screening for FMD

2.Medical management

Antiplatelet therapy: consider initiating daily antiplatelet therapy (aspirin, 81 mg) in patients with RAA.
C

3.Therapeutic procedures

Indications for repair: perform emergent intervention for any size RAA resulting in patient symptoms or rupture.
B
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  • Endovascular repair

4.Perioperative care

Postoperative imaging: consider obtaining completion imaging after open surgical reconstruction for RAA, before hospital discharge, by way of axial imaging with CTA or MRA or arteriography in selected patients, and long-term follow-up with surveillance imaging.
C

5.Surgical interventions

Surgical repair: consider performing open surgical reconstruction for the elective repair of most RAAs in patients with acceptable operative risk.
C
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6.Follow-up and surveillance

Surveillance imaging
Consider obtaining annual surveillance imaging until two consecutive studies are stable and every 2-3 years thereafter in patients with RAA managed nonoperatively.
C
Consider obtaining long-term surveillance imaging in patients with repaired RAA.
C