Aneurysms of the renal artery - Causes, Symptoms and Treatment .MF .
Aneurysms of the renal artery - a sack-bulging of the renal artery wall, in which the blood circulates.On the structure of the renal artery aneurysms are divided into true and false.If true aneurysms consist of all sections of the artery, the false image of the muscular wall prolapse and bulging exclusively mucosa.
Types of aneurysm and its rupture
Causes of aneurysms of the renal arteries
most common cause of renal artery aneurysms are systemic metabolic diseases that affect the structure and tone of blood vessels.The most common such disease is atherosclerosis which is hitting the intima of blood vessels, leading to decreased formation and last tone of the bag bulging therein.
great importance in the pathogenesis of this disease is the pressure inside the blood vessel.For example, if the person suffers hypertension, atherosclerosis associated, then he risk of renal artery aneurysm is much higher than any other patient.
addition, there are other disease states that can lead to renal artery a
Symptoms of renal artery aneurysm
Typically, when small size of the aneurysm of the renal artery , they have no clinical manifestations and occur completely asymptomatic.The first symptoms appear after the formation reaches the impressive size and will break its wall.
Symptoms arising due to the massive size of the aneurysm , arises due to the pressure on its neighboring anatomical structures.The closest to the body is renal artery ureter - the tube through which urine comes outflow from the kidney to the bladder.In the latter by displacement urine, lingering in the kidneys cavity leads to expansion of the renal pelvis and thus malfunction of the organ.This immediately affects the general condition, as occurs in patients with uremia state - a common infection of the blood urinary toxins.At the same time a marked general weakness, malaise, headaches and unpleasant smell of acetone breath.In the absence of adequate treatment of such condition may result in uraemic shock and death.
Also, quite often in patients with renal artery aneurysms, blood clots are formed receptacles.This leads to a complete cessation of blood supply to the kidneys, which ends kidney myocardial same uraemic shock.
more severe symptoms seen with rupture of renal artery aneurysm .It manifests itself in two clinical syndromes: pain and anemic.Patients report a sharp pain in the lumbar region, which appears, as a rule, after physical stress or trauma, even if minor.Over time it fades, but there are complaints of shortness of breath, general weakness, malaise, and severe persistent headaches.Such patients are apathetic, their skin and mucous membranes pale.
If the patient observed the above symptoms or he holds a systemic atherosclerosis, it should immediately seek help from a urologist to rule out the diagnosis of renal artery aneurysm.
diagnosis of renal artery aneurysms
In this disease a common blood and urine tests are absolutely "quiet."Increasing the number of white blood cells can be seen only in the case of rupture of the aneurysm of the renal artery and inflammation of adipose tissue of the retroperitoneal space.
Visualize education is by ultrasound.Its dimensions, as a rule, do not exceed one centimeter in diameter, and most education pulsates in time with the heart contractions.During the ultrasound Doppler mode can be distinguished from the formation of an aneurysm of any other origin.If an aneurysm of the renal artery fills with blood during contractions of the heart, the malignant and benign tumors of blood vessels supplying the individual.
«gold standard" in the diagnosis of renal artery aneurysms angiography is considered.The method consists in the fact that using a special catheter is a water-soluble contrast is injected into the cavity of the aorta.Then the bloodstream it is distributed through the vessels and into the renal artery, completely filling the latter.If at this moment to carry out X-ray examination of the anatomical site, you can see for yourself how the renal arteries and the aneurysm formed.
angiography: renal artery aneurysm
Treatment of renal artery aneurysms
In the absence of clinical symptoms and hemodynamic stable picture with respect to renal artery aneurysm expectant management can be applied.At the same time each month during the year performed ultrasonography of the kidneys with the definition of the size of the aneurysm.
If in the course of this investigation it is found that an aneurysm tends to increase, or the patient is disturbed general condition, then there is a need for surgical intervention.Previously, these operations were carried out only by open way, when an aneurysm tie up at the base and was excised.To date, such surgery is not carried out, due to the rapid development of minimally invasive techniques.Now widely used intravascular operation, such as the obliteration of an aneurysm of the renal artery.To do this in the aneurysm cavity introduced a special catheter, similar to the one that Angiography was performed.After that, from his beginning to introduce a special substance, which immediately freezes, "zamurovyvaya" aneurysm.
The advantages of this method is that it is performed under local anesthesia and the patient the next day after surgery can easily move around the office, and after three days and did discharged from the hospital.The only drawback of the operation can be considered as its cost as it costs a patient is much more expensive than conventional open surgery.
rehabilitation after illness
rehabilitation after an illness depends on which surgery was performed.If it is a minimally invasive procedure, patients need only antibacterial prevention of secondary infection.This may be used and such means as cephalosporin or ampicillin, which are broad-spectrum antibiotics.
much heavier flows postoperative period in patients undergoing open surgery.They are not enough to recover only one antibacterial therapy.At the same time actively used in the form of physiotherapy or the use of magnetic therapy UHF.
Feeding habits and lifestyle
Since, in most cases, renal artery aneurysms are the consequences of systemic atherosclerosis, correction of lifestyle in the first place, it should be directed to the treatment of this disease.For this purpose can be used drugs, lowering blood lipid levels.Among the most famous can be identified rosuvastatin.
very gentle way of life is necessary to keep those patients who refuse surgery.They have a strong physical exertion can cause rupture of the aneurysm of the renal artery, so it is absolutely contraindicated in such patients.
Treatment folk remedies
As already mentioned, the only effective treatment for renal artery aneurysm is surgery.As a prompt intervention in the community is not possible, we can not speak about the effectiveness of treatment of folk remedies.All other attempts to cure the disease without surgery is unsuccessful.
Complications of aneurysms of the renal artery
The most dangerous complication of renal artery aneurysm should be considered as hypovolemic shock, which occurs due to rupture of the latter.In this clinical picture depends on the amount of blood lost.If the amount of fluid lost during rupture is not more than 500 ml, the patient may not experience any clinical signs.If the amount of blood lost more than 2 liters, this situation typically ends patient death.
Another serious complication of renal artery aneurysm should be considered as hydronephrosis - expansion of the renal pelvis and parenchyma thinning it.This occurs when the compression of the aneurysm ureter when urine can not flow away freely from the cavity kidneys.At the same time, patients complain of arching pain in the lumbar region, and violation of urination.Quite often, hydronephrosis is complicated pyelonephritis.Then to the above is added the complaints and fever.
For small rupture of the aneurysm, thrombosis occurs when the artery defect occurs retroperitoneal hematoma.In the case where it resolves, the patient's condition improves.If a hematoma secondary infection joins, then there is abscess retroperitoneal fat.In patients observed complaints of fever, malaise, general weakness and pain in the lumbar region.In the absence of adequate treatment for the condition may go into the general blood poisoning, called septicemia.As with hypovolemic shock, the high mortality rate is also registered in sepsis.
Prevention of renal artery aneurysms
Since the formation of aneurysms of the renal arteries is very much influenced by systemic atherosclerosis, primary prevention must be directed precisely to the treatment of this disease.All patients must adhere to lipid-lowering diet with a low-fat foods.In addition, the recommended daily life use antiatherosclerotic agents such as rosuvastatin.
Ed.urologist, sexologist-andrologist Plotnikov AN