Mycotic Renal Artery Aneurysm Repair with a Covered Stent

Mycotic renal artery aneurysms are rarely seen. Because the renal artery is located deep within the retroperitoneum, open surgical repair is highly invasive. Endovascular repair with a covered stent, followed by an adequate antibiotic regimen, may offer a treatment alternative for elderly and emaciated patients. We report the first case of using a covered stent in treating a mycotic renal artery aneurysm. The 82-year-old male was sent to our hospital due to abdominal pain and fever, and computed tomography (CT) scan preliminarily indicated a retroperitoneal abscess at the right renal hilum. After a CT-guided aspiration, which revealed fresh blood, a mycotic aneurysm of the right renal artery was then diagnosed. Retroperitoneal bleeding was successfully curtailed with a 6 x 60 mm covered stent. Blood cultures were negative. Empirical intravenous antibiotics to prevent Salmonella were administered. Four weeks later, the patient was discharged without any symptom or sign of infection, and no infection recurrence was noted in the following 11 months.