Version July 2025
CT: computed tomography; MR: magnetic resonance; RAA: renal artery aneurysm; RAS: renal artery stenosis; VAA: visceral artery aneurysm; VAPA: visceral artery pseudoaneurysm.
* Asymptomatic aneurysms are typically identified on vascular ultrasound or cross-sectional CT or MR either during the evaluation of those with risk factors (eg, fibromuscular dysplasia, celiac artery compression syndrome, connective tissue disorders) or incidentally while evaluating another abdominal condition.
¶ Abdominal pain may be associated with aneurysm enlargement, thrombosis leading to pain from end-organ ischemia, or rupture. Free rupture will also cause hemodynamic compromise. Refer to other UpToDate content on diagnostic evaluation of symptomatic renal artery or visceral artery aneurysms.
Δ RAA/VAA can be multiple within the same renal or visceral arterial bed or associated with other VAA. As an example, 1/3 of patients with splenic artery aneurysm have other associated RAA or VAA. VAPA is more often isolated.
◊ RAA/VAA can be associated with aneurysms in other arterial beds (eg, intracranial aneurysm, carotid artery aneurysm). RAA can also be associated with fibromuscular dysplasia. Refer to UpToDate content for more information on these associations.
§ CT or MR angiography or sometimes catheter-based angiography is used to evaluate anatomy prior to repair. For celiac artery aneurysm, evaluate the mesenteric circulation to determine whether mesenteric revascularization is needed. The approach to repair (open, endovascular) depends on the aneurysm location and extent, anatomic features (eg, shape, length, position in the vascular bed), patient comorbidities, and gestational age for those who are pregnant.
¥ Imaging surveillance typically uses CT or MR angiography with the selection based on patient characteristics. If annual imaging is stable on 2 consecutive studies, the imaging interval can be extended to every 2 to 3 years.
