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Renal artery aneurysm

Updated June 24, 2025

Guidelines

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 European Society for Vascular Surgery (ESVS 2025) and the Society for Vascular Surgery (SVS 2020).

Diagnostic investigations

Diagnostic imaging: as per ESVS 2025 guidelines, obtain CTA for diagnosis, anatomical characterization, and procedure planning in patients with suspected visceral artery aneurysm.

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Medical management

Antiplatelet therapy: as per SVS 2020 guidelines, consider initiating daily antiplatelet therapy (aspirin, 81 mg) in patients with RAA.

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Therapeutic procedures

Indications for repair: as per ESVS 2025 guidelines, perform urgent repair in patients with a symptomatic visceral artery aneurysm, regardless of size and location.

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Perioperative care

Postoperative imaging: as per SVS 2020 guidelines, 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.

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Specific circumstances

Pregnant patients: as per ESVS 2025 guidelines, consider performing endovascular or open treatment in pregnant patients with a RAA, regardless of aneurysm size.

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Follow-up and surveillance

Surveillance imaging: as per ESVS 2025 guidelines, consider obtaining annual surveillance for the first 3 years and individualized thereafter, preferably with duplex ultrasound and otherwise CTA, in patients with an asymptomatic visceral artery aneurysm with a diameter < 30 mm.

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