杨宁介入医学网

        首次报告肾动脉瘤是在1770年，Rouppe 报告了一个海员之死，尸检显示其死于肾的假性动脉瘤破裂[17]。肾动脉瘤可以分为肾实质动脉瘤和肾实质外动脉瘤。以前曾经认为肾动脉瘤是非常罕见的，随着CT，MRI和超声的出现，肾动脉瘤被偶然发现的病例越来越多，并不罕见。

       过去30年间，肾动脉及其分支的动脉瘤越来越多地受到关注【1~15】。

（1）肾动脉瘤的发病率在0.01~0.1%之间【16】。Stanley 等人认为人群中发病率为0.09%。

（2）在进行血管造影的人群中为0.01~1%，Tham 等人报告【7】1970~1979年进行肾动脉造影的8525例病人中发现肾动脉瘤83例（0.97%）。（0.3 % - 1 % in renal angiography studies）

（3）而在进行血管造影的高血压人群中为2.5%。尸检研究为0.01%【18】。（0.01 % in autopsy studies）

（4）占内脏动脉瘤的20-25% 。36656例尸检，19例内脏动脉瘤破裂，没有肾动脉瘤的破裂。（22% of all VAAs）

（5）平均年龄46±18岁，女性占68%【20】。

（6） 肾实质内肾动脉瘤非常罕见，占肾动脉瘤病人的10%以下，常规尸检很难看到。右肾比左肾更常见。双侧肾动脉瘤少于7%，而且常见为多发肾动脉瘤。  右肾比左肾更常受到累及（60%），双侧肾动脉瘤少于7%【7】，多发更常见。

Fibromuscular dysplasia

右颈内动脉瘤	右肾动脉主干梭形和囊性动脉瘤	左肾动脉多发动脉瘤

（7）肾动脉瘤的体积从0.5CM~8CM不等。 肾动脉瘤破裂的危险在5~6%。

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