Endovascular treatment of complex renal artery aneurysm with Pipeline flow-diverter: A case report.

A 61-year-old male with hypertension and remote 35-year history of smoking was found to have a large peripherally calcified left renal artery aneurysm (RAA) on computer tomography imaging. An initial attempt to stent and coil-embolize the aneurysm was unsuccessful despite sufficient access due to the angulation and tortuosity of the aneurysmal sac which was not conducive to a typical stent graft. The patient ultimately declined to undergo open surgical repair of the aneurysm and thus prompted the consideration of stent grafts typically reserved for neurointerventional cases. In this report, we present a case in which a large, complex Rundback type 1 renal artery aneurysm was treated using a flow-diverting stent, a device which is typically used to treat intracranial aneurysms. The case was a technical success and effectively treated the patient's RAA. The use of a neurovascular stent within visceral arteries adds to the existing literature describing the use of Pipeline flow-diverting stent in renal vasculature and demonstrates an alternate treatment option to traditional stenting which may better preserve kidney perfusion.