Renal Artery Pseudoaneurysm Following Laparoscopic Partial Nephrectomy

Edan Y. Shapiro, A. Ari Hakimi, Elias S. Hyams, Jacob Cynamon, Michael Stifelman, Reza Ghavamian

Research output: Contribution to journalArticle

35 Citations (Scopus)

Abstract

Objectives: To present our experience with the management of renal artery pseudoaneurysms following laparoscopic partial nephrectomy (LPN). Methods: Our bi-institutional LPN database of 259 patients from July 2001 to April 2008 was queried for patients diagnosed with a postoperative renal artery pseudoaneurysm. Demographic data, perioperative course, complications, and follow-up studies in identified subjects were analyzed. Postembolization success was defined as symptomatic relief, resolution of hematuria, and a stable hematocrit and serum creatinine. Results: We identified 6 patients (2.3%) who were diagnosed with a renal artery pseudoaneurysm after LPN. The mean age of our cohort was 61.2 years (49-76), mean operative time was 208 minutes (140-265), and mean estimated blood loss was 408 mL (50-800). Patients presented at a mean of 12.6 days (5-23) after the initial surgery. Five patients had gross hematuria and a decreased hematocrit, with 1 patient presenting with clinical symptoms of hypovolemia. The sixth patient was incidentally diagnosed. The diagnosis of a renal artery pseudoaneurysm was confirmed in all cases by angiography. Selective angioembolization was successfully performed in all patients. At a median follow-up of 8.3 months all patients (100%) remained without any evidence of recurrence. Conclusions: Although pseudoaneuryms are a rare postoperative complication of LPN, they are potentially life-threatening. Early identification and proper management can help reduce the potential morbidity associated with pseudoaneurysms. Our experience demonstrates the feasibility and supports the use of selective angioembolization as an excellent first-line option for patients who present with this form of delayed bleeding.

Original languageEnglish (US)
Pages (from-to)819-823
Number of pages5
JournalUrology
Volume74
Issue number4
DOIs
StatePublished - Oct 2009

Fingerprint

False Aneurysm
Renal Artery
Nephrectomy
Hematuria
Hematocrit
Hypovolemia
Operative Time
Creatinine
Angiography
Demography
Databases
Hemorrhage
Morbidity
Recurrence

ASJC Scopus subject areas

  • Urology

Cite this

Shapiro, E. Y., Ari Hakimi, A., Hyams, E. S., Cynamon, J., Stifelman, M., & Ghavamian, R. (2009). Renal Artery Pseudoaneurysm Following Laparoscopic Partial Nephrectomy. Urology, 74(4), 819-823. https://doi.org/10.1016/j.urology.2009.03.056

Renal Artery Pseudoaneurysm Following Laparoscopic Partial Nephrectomy. / Shapiro, Edan Y.; Ari Hakimi, A.; Hyams, Elias S.; Cynamon, Jacob; Stifelman, Michael; Ghavamian, Reza.

In: Urology, Vol. 74, No. 4, 10.2009, p. 819-823.

Research output: Contribution to journalArticle

Shapiro, EY, Ari Hakimi, A, Hyams, ES, Cynamon, J, Stifelman, M & Ghavamian, R 2009, 'Renal Artery Pseudoaneurysm Following Laparoscopic Partial Nephrectomy', Urology, vol. 74, no. 4, pp. 819-823. https://doi.org/10.1016/j.urology.2009.03.056
Shapiro EY, Ari Hakimi A, Hyams ES, Cynamon J, Stifelman M, Ghavamian R. Renal Artery Pseudoaneurysm Following Laparoscopic Partial Nephrectomy. Urology. 2009 Oct;74(4):819-823. https://doi.org/10.1016/j.urology.2009.03.056
Shapiro, Edan Y. ; Ari Hakimi, A. ; Hyams, Elias S. ; Cynamon, Jacob ; Stifelman, Michael ; Ghavamian, Reza. / Renal Artery Pseudoaneurysm Following Laparoscopic Partial Nephrectomy. In: Urology. 2009 ; Vol. 74, No. 4. pp. 819-823.
@article{a6835f945e584c0abfdf0389bb99d401,
title = "Renal Artery Pseudoaneurysm Following Laparoscopic Partial Nephrectomy",
abstract = "Objectives: To present our experience with the management of renal artery pseudoaneurysms following laparoscopic partial nephrectomy (LPN). Methods: Our bi-institutional LPN database of 259 patients from July 2001 to April 2008 was queried for patients diagnosed with a postoperative renal artery pseudoaneurysm. Demographic data, perioperative course, complications, and follow-up studies in identified subjects were analyzed. Postembolization success was defined as symptomatic relief, resolution of hematuria, and a stable hematocrit and serum creatinine. Results: We identified 6 patients (2.3{\%}) who were diagnosed with a renal artery pseudoaneurysm after LPN. The mean age of our cohort was 61.2 years (49-76), mean operative time was 208 minutes (140-265), and mean estimated blood loss was 408 mL (50-800). Patients presented at a mean of 12.6 days (5-23) after the initial surgery. Five patients had gross hematuria and a decreased hematocrit, with 1 patient presenting with clinical symptoms of hypovolemia. The sixth patient was incidentally diagnosed. The diagnosis of a renal artery pseudoaneurysm was confirmed in all cases by angiography. Selective angioembolization was successfully performed in all patients. At a median follow-up of 8.3 months all patients (100{\%}) remained without any evidence of recurrence. Conclusions: Although pseudoaneuryms are a rare postoperative complication of LPN, they are potentially life-threatening. Early identification and proper management can help reduce the potential morbidity associated with pseudoaneurysms. Our experience demonstrates the feasibility and supports the use of selective angioembolization as an excellent first-line option for patients who present with this form of delayed bleeding.",
author = "Shapiro, {Edan Y.} and {Ari Hakimi}, A. and Hyams, {Elias S.} and Jacob Cynamon and Michael Stifelman and Reza Ghavamian",
year = "2009",
month = "10",
doi = "10.1016/j.urology.2009.03.056",
language = "English (US)",
volume = "74",
pages = "819--823",
journal = "Urology",
issn = "0090-4295",
publisher = "Elsevier Inc.",
number = "4",

}

TY - JOUR

T1 - Renal Artery Pseudoaneurysm Following Laparoscopic Partial Nephrectomy

AU - Shapiro, Edan Y.

AU - Ari Hakimi, A.

AU - Hyams, Elias S.

AU - Cynamon, Jacob

AU - Stifelman, Michael

AU - Ghavamian, Reza

PY - 2009/10

Y1 - 2009/10

N2 - Objectives: To present our experience with the management of renal artery pseudoaneurysms following laparoscopic partial nephrectomy (LPN). Methods: Our bi-institutional LPN database of 259 patients from July 2001 to April 2008 was queried for patients diagnosed with a postoperative renal artery pseudoaneurysm. Demographic data, perioperative course, complications, and follow-up studies in identified subjects were analyzed. Postembolization success was defined as symptomatic relief, resolution of hematuria, and a stable hematocrit and serum creatinine. Results: We identified 6 patients (2.3%) who were diagnosed with a renal artery pseudoaneurysm after LPN. The mean age of our cohort was 61.2 years (49-76), mean operative time was 208 minutes (140-265), and mean estimated blood loss was 408 mL (50-800). Patients presented at a mean of 12.6 days (5-23) after the initial surgery. Five patients had gross hematuria and a decreased hematocrit, with 1 patient presenting with clinical symptoms of hypovolemia. The sixth patient was incidentally diagnosed. The diagnosis of a renal artery pseudoaneurysm was confirmed in all cases by angiography. Selective angioembolization was successfully performed in all patients. At a median follow-up of 8.3 months all patients (100%) remained without any evidence of recurrence. Conclusions: Although pseudoaneuryms are a rare postoperative complication of LPN, they are potentially life-threatening. Early identification and proper management can help reduce the potential morbidity associated with pseudoaneurysms. Our experience demonstrates the feasibility and supports the use of selective angioembolization as an excellent first-line option for patients who present with this form of delayed bleeding.

AB - Objectives: To present our experience with the management of renal artery pseudoaneurysms following laparoscopic partial nephrectomy (LPN). Methods: Our bi-institutional LPN database of 259 patients from July 2001 to April 2008 was queried for patients diagnosed with a postoperative renal artery pseudoaneurysm. Demographic data, perioperative course, complications, and follow-up studies in identified subjects were analyzed. Postembolization success was defined as symptomatic relief, resolution of hematuria, and a stable hematocrit and serum creatinine. Results: We identified 6 patients (2.3%) who were diagnosed with a renal artery pseudoaneurysm after LPN. The mean age of our cohort was 61.2 years (49-76), mean operative time was 208 minutes (140-265), and mean estimated blood loss was 408 mL (50-800). Patients presented at a mean of 12.6 days (5-23) after the initial surgery. Five patients had gross hematuria and a decreased hematocrit, with 1 patient presenting with clinical symptoms of hypovolemia. The sixth patient was incidentally diagnosed. The diagnosis of a renal artery pseudoaneurysm was confirmed in all cases by angiography. Selective angioembolization was successfully performed in all patients. At a median follow-up of 8.3 months all patients (100%) remained without any evidence of recurrence. Conclusions: Although pseudoaneuryms are a rare postoperative complication of LPN, they are potentially life-threatening. Early identification and proper management can help reduce the potential morbidity associated with pseudoaneurysms. Our experience demonstrates the feasibility and supports the use of selective angioembolization as an excellent first-line option for patients who present with this form of delayed bleeding.

UR - http://www.scopus.com/inward/record.url?scp=70349451685&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=70349451685&partnerID=8YFLogxK

U2 - 10.1016/j.urology.2009.03.056

DO - 10.1016/j.urology.2009.03.056

M3 - Article

VL - 74

SP - 819

EP - 823

JO - Urology

JF - Urology

SN - 0090-4295

IS - 4

ER -