Combined Renal Artery Stenosis and Renal Artery Aneurysm As a Cause of Renovascular Hypertension: A Case Report

Over the last decade there has been an increased awareness of renovascular disease as a potentially correctable cause of hypertension and renal insufficiency. Renal artery stenosis is most commonly due to either atherosclerosis or fibromuscular dysplasia. Renal artery aneurysms are uncommon and they can be seen alone or accompanying stenosis or arteriovenous fistulas. Although the reported incidence of renal artery aneurysms is rare, the common use of angiography has led to an increase in the diagnosis of renal artery aneurysms (0.09%). Though mostly clinically silent and asymptomatic, RAA may occasionally cause renovascular hypertension, abdominal pain, hematuria and renal artery thrombosis. When indicated, endovascular embolization and surgery are the treatment modalities for both renal artery stenosis and aneurysms. We report a case with a 25 year history of essential hypertension which became uncontrolled within the last two years due to renal artery stenosis and aneurysm. Stent application and endovascular embolisation of the aneurysm resulted in successful control of blood pressure.