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In this case report, we outline our novel approach in treating a complex type III RAA of a man in his 70s, who presented with right side abdominal and flank pain with persisting haematuria. The patient underwent a successful percutaneous endovascular procedure with placement of a C-Guard stent as a flow diverting device. Our satisfactory results, with preservation of all side branches, resolution of the patient\u2019s symptomatology, improvement of blood pressure control, persisted at 12 months follow-up, along with complete exclusion of the aneurysm from the circulation. The dual-layer design of the C-Guard stent, even though initially designed for treatment of carotid artery disease, effectively stabilised the aneurysm and safeguarded the side branches while minimising complications.<\/jats:p>","DOI":"10.1136\/bcr-2025-265436","type":"journal-article","created":{"date-parts":[[2025,7,7]],"date-time":"2025-07-07T17:50:30Z","timestamp":1751910630000},"page":"e265436","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Management of complex symptomatic renal artery aneurysm in a patient with Sj\u00f6gren\u2019s syndrome and systemic lupus erythematosus"],"prefix":"10.1136","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8767-4929","authenticated-orcid":false,"given":"Sherif","family":"Sultan","sequence":"first","affiliation":[{"name":"Vascular and Endovascular Surgery, Galway University Hospital, Galway, Ireland"},{"name":"Vascular and Endovascular Surgery, Western Vascular Institute, Galway, Ireland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1674-0030","authenticated-orcid":false,"given":"Kalliopi-Maria","family":"Tasopoulou","sequence":"additional","affiliation":[{"name":"Vascular and Endovascular Surgery, Galway University Hospital, Galway, Ireland"},{"name":"Vascular and Endovascular Surgery, Western Vascular Institute, Galway, Ireland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Osama","family":"Soliman","sequence":"additional","affiliation":[{"name":"Cardiovascular Research Institute, Dublin, Ireland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"William","family":"Wijns","sequence":"additional","affiliation":[{"name":"The Lambe Institute for Translational Medicine and Curam, University of Galway, Galway, Ireland"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2025,7,7]]},"reference":[{"key":"2025082709124983000_18.7.e265436.1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvs.2015.05.034"},{"key":"2025082709124983000_18.7.e265436.2","doi-asserted-by":"publisher","DOI":"10.1016\/S1051-0443(07)61362-1"},{"key":"2025082709124983000_18.7.e265436.3","doi-asserted-by":"crossref","unstructured":"Li F , Li S , Cao Z , et al . 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