Hidden Renal Artery Pseudoaneurysm: The Need for Repeat Angiographic Intervention in a Symptomatic Patient.

Renal artery pseudoaneurysm (RAP) is a well-known and life-threatening complication of partial nephrectomies. Angioembolization is the preferred intervention, allowing for visualization, diagnosis, and treatment in 96% of cases. We report a case of a pseudoaneurysm that was difficult to diagnose even with optimal technique, requiring repeat imaging and additional angiographic intervention. Our case shows that RAP after partial nephrectomies may be difficult to diagnose even with high suspicion and appropriate technique. Repeat angiography may be required. Urologists and interventional radiologists together must keep RAP high on the differential even after a negative angiogram to adequately diagnose and treat symptomatic patients.