Growth patterns of true renal artery aneurysms in the current published literature.
Objective: To describe the methods of surveying true renal artery aneurysms (RAAs) and identify the pattern of growth of RAA in the current literature.
Methods: A comprehensive electronic database search was performed. The limits applied included full text and English language. The reference lists of included publications were manually searched for further relevant studies. Studies that surveyed RAA on imaging and calculated mean aneurysm growth rates per year were included.
Results: Literature review yielded six studies comprising 876 patients and approximately 988 aneurysms. Computed tomography (CT) was the most common imaging modality utilised for evaluation of RAA. Mean initial RAA diameter ranged from 1.21 to 1.6 cm. The combined cohort was followed radiologically for up to a maximum of 142 months and reports a zero percent rupture rate. Mean growth rates were consistently below 0.1 cm/y across the included studies (range: 0.017-0.086 cm/y).
Conclusions: The present study highlights a benign course of RAA. The current evidence yields a rupture rate of zero in a combined cohort of approximately 988 aneurysms followed for up to 11 years. Future guidelines should recognise this indolent course and consider rationalisation of RAA surveillance, particularly where initial aneurysm size is well below the threshold for treatment.