Most people have never heard of the splenic or renal arteries — and that is completely normal. These are blood vessels that carry blood to your spleen and kidneys, and like the arteries in your heart and legs, they can narrow over time. When that happens, your organs may not get the blood flow they need. The good news is that this kind of narrowing can often be treated without major surgery.
Renal Artery Stenosis
Renal artery stenosis is a narrowing of one or both arteries supplying the kidneys, reducing blood flow and triggering the renin-angiotensin system — a hormonal mechanism that raises blood pressure in an attempt to maintain kidney perfusion. The result is renovascular hypertension, which is often severe, difficult to control with medications, and potentially reversible with treatment of the underlying stenosis. In advanced cases, reduced perfusion leads to ischemic nephropathy and permanent kidney damage.
Splenic Artery Disease
The splenic artery is the most common site for visceral artery aneurysm — a localized dilation of the vessel that carries risk of rupture, particularly during pregnancy. Atherosclerotic splenic artery stenosis may cause spleen ischemia or be asymptomatic. Splenic artery aneurysms larger than 2 cm in women of childbearing age or aneurysms of any size with symptoms require intervention.
Diagnosis and Treatment
Duplex ultrasound is the first-line screening test for renal artery stenosis, detecting elevated velocities that indicate significant narrowing. CT angiography provides anatomical detail for treatment planning. Renal artery stenting (percutaneous transluminal angioplasty and stenting) is the preferred revascularization method for atherosclerotic renal artery stenosis, restoring blood flow to the kidney and in selected patients improving blood pressure control. Splenic artery aneurysms are treated with coil embolization or open surgical ligation.