Suprarenal Aneurysm

Definition

A suprarenal aneurysm is bulging and weakness in the aorta located above the kidneys. A suprarenal aneurysm can burst, which can cause bleeding. However, most aortic aneurysms occur below the renal arteries (known as infrarenal aneurysms).

Causes

The exact causes of suprarenal aneurysms are not known, though atherosclerosis (hardening of the arteries caused by a buildup of fatty substances, plaque and other elements) is believed to play a key role.

Risk

• Being older than 60
• Being a man — suprarenal aneurysms are four to five times more likely to occur in men
• Family history of aneurysms
• High cholesterol
• High blood pressure
• Smoking
• Diabetes
• Genetic disorders (such as Marfan syndrome, Ehlers-Danlos syndrome, Turner's syndrome and polycystic kidney disease) that affect connective tissue like bones, cartilage, heart and blood vessels
  

• Infections of aorta
  

Symptoms

Suprarenal aneurysms usually occur with no symptoms. When symptoms do occur, they generally include:

• Severe or dull pain in the abdomen, chest, lower back or groin
• Sharp, sudden pain in the back or abdomen (may signal a rupturing aneurysm)
  

Diagnosis

• Ultrasound Imaging: Sound waves are used to measure blood flow in the arteries and determine whether there is an aneurysm. This test may not be useful for infrarenal arteries.
• Computed Tomography (CT) scan: X-ray slices of the aortic artery are taken to determine if there are any aneurysms.
• Magnetic Resonance Angiography (MRA): Radio waves and magnetic fields are used to show areas of poor blood flow. Patients are injected with a contrast material – similar to a dye – to make blood vessels more visible.
  

Treatment

• Close monitoring: Regular screenings that can check the size and growth of a suprarenal aneurysm is the first step in determining if treatment is necessary.
• Lifestyle changes: Steps such as quitting smoking, controlling your diabetes and high blood pressure and eating a low-fat diet to reduce your cholesterol may help keep aneurysms from growing. Heavy lifting should also be avoided.
• Medication: Medicines to reduce cholesterol or high blood pressure are also used to help control the growth of aneurysms.
• Surgery: Surgical repair is now the usual option for aneurysms 6 cm or larger, though endovascular repair of these larger aneurysms with branches to the kidney arteries will eventually be available to repair suprarenal as well as infrarenal aneurysms.