Flow Diversion Beyond the Brain: Endovascular Management of Wide-Neck Renal Artery Aneurysms Using Flow-Diverting Stents.

The therapeutic management of wide-neck renal artery aneurysms (RAAs) is challenging due to their frequent involvement of bifurcation points and variable shapes, such as lobulated sacs or wide necks that complicate treatment planning. Flow-diverting stents have emerged as an endovascular option for the treatment of complex intracranial aneurysms. However, their application in RAAs remains underreported. In this retrospective case series, we describe three female patients with four wide-neck RAAs treated at a single institution between January 2024 and January 2025. Two aneurysms were located in the left renal artery and two in the right, including one involving a bifurcation. All patients underwent endovascular repair using flow-diverter stents, with or without adjunctive coil embolization. Clinical and imaging data were reviewed. All procedures were successful, achieving complete aneurysm occlusion and preserving renal artery flow. All patients recovered without any complications and were discharged within 24 hours of the procedure. Aneurysm occlusion and preserved parenchymal flow were verified with follow-up imaging at three to six months. Flow-diverters, whether used alone or in conjunction with coil embolization, are a safe and feasible endovascular option for treating wide-neck RAAs, including lesions located at arterial branch points. These findings support the feasibility of minimally invasive treatment in complex renal vascular anatomy.