Renal Artery Aneurysm – ACR 2013

Aneurysm DiameterImaging Interval
1.0 - 1.5 cm1-2 year follow-up imaging
>1.5 - 2.0 cmConsider surgical or endovascular repair
  • “Etiologies include fibromuscular dysplasia (FMD), atherosclerosis, and pseudoaneurysms that may occur after trauma.”
  • “RAAs related to FMD should be considered when there is a classic ‘string of beads’ appearance to the renal artery or when aneurysms occur in younger women, especially when associated with hypertension.”
  • “Pseudoaneurysms typically occur after trauma and are usually located within the parenchyma of the kidney.”
  • “Other aneurysms, not related to FMD or trauma, typically occur at branch points in the renal artery.”
  • Decision to repair a renal artery aneurysm depends on patient age, gender, aneurysm size, and presence of uncontrolled hypertension.

Reference: Khosa F, Krinsky G, Macari M, Yucel EK, Berland LL. Managing Incidental Findings on Abdominal and Pelvic CT and MRI, Part 2: White Paper of the ACR Incidental Findings Committee II on Vascular Findings. J Am Coll Radiol 2013;10:789-794.