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. 2018;1(1):12.
doi: 10.1186/s42155-018-0018-0. Epub 2018 Oct 3.

Balloon-assisted coil embolization (BACE) of a wide-necked renal artery aneurysm using the intracranial scepter C compliant occlusion balloon catheter

Jeeban Paul Das  1 , Hamed Asadi  1 , Hong Kuan Kok  1 , Emma Phelan  1 , Alan O'Hare  1 , Michael J Lee  1
Affiliations

Balloon-assisted coil embolization (BACE) of a wide-necked renal artery aneurysm using the intracranial scepter C compliant occlusion balloon catheter

Jeeban Paul Das et al. CVIR Endovasc. 2018.

Abstract

Background: True renal artery aneurysms (TRAA) are an uncommon pathology, with a prevalence of less than 1%. Treatment of TRAAs is generally recommended when the aneurysm sac equals or exceeds 2cms. Both wide-necked and main renal artery branch aneurysms represent a challenge for conventional endovascular coil embolization due to the risk of coil migration.

Main body: Intra-procedural remodeling of the aneurysm neck using Balloon Assisted Coil Embolization (BACE) is considered a suitable alternative in challenging cases of visceral artery aneurysms.

Short conclusion: We describe the novel use of the Scepter C (MicroVention Terumo, Tustin, CA) compliant double lumen neurovascular occlusion balloon in the treatment of a wide-necked branch TRAA in a patient with a solitary kidney.

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Conflict of interest statement

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.Consent was obtained from all individual participants included in the study.The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
a CTA demonstrating a solitary left kidney with a wide-necked 2 cm saccular aneurysm (arrow) arising from the left renal artery anterior division (arrow head). b Volume-rendered 3D CTA reconstruction demonstrating the left TRAA morphology arising from the anterior division (arrow) just distal to the left renal artery bifurcation
Fig. 2
Fig. 2
a Selective angiography of the left renal artery anterior division confirming the presence of a 2 cm wide-necked saccular aneurysm (arrow). The parent renal artery demonstrates a beaded appearance suggestive of fibromuscular dysplasia (arrow head). b Re-modelling of the wide-necked TRAA using the Scepter C balloon (arrow) which is inflated across the aneurysm neck. The coiling microcatheter tip has been positioned within the aneurysm sac. Angiography through the guide sheath shows occlusion of flow within the aneurysm sac and distal anterior division branch. c Fluoroscopic image demonstrating the inflated Scepter C balloon (arrow) with delivery of the initial detachable coil within aneurysm sac (arrow head). d Final completion angiography demonstrating complete obliteration of the aneurysm sac by a dense coil ball (arrow) with preservation of flow into the distal anterior division branch and renal parenchyma. e Follow-up CT angiogram at 3 months demonstrating persistent occlusion of the TRAA sac with normal solitary kidney parenchymal enhancement
See this image and copyright information in PMC

References

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