Renal artery aneurysms in pregnancy-Management of an uncommon but serious vascular lesion

Abstract

Renal artery aneurysm (RAA) is defined as a localized saccular or fusiform dilation of the renal vasculature that exceeds 50% of the adjacent artery diameter. RAAs are rare in the general population and account for <1% of all peripheral aneurysms. Incidental diagnosis of RAA has increased due to the widespread clinical application of visceral duplex ultrasound scanning and computed tomography imaging. While the diagnosis of RAA before or during pregnancy is rare, pregnancy increases the risk of rupture significantly during the third trimester, with associated high mortality rates for both mother and fetus. The rarity of pregnancy-related RAAs contributes to our limited knowledge of their natural history, morphologic features, criteria for intervention, and treatment options. This review compiles opinions of published articles to provide an updated overview of RAA in pregnancy and aid clinicians in the management of this rare but serious vascular condition. An RAA 1.5 cm in diameter requires open or endovascular treatment in a woman planning to become pregnant or who is pregnant.