Isolated Spontaneous Renal Artery Dissection: Endovascular Management

We report a rare case of isolated spontaneous renal artery dissection treated by stent placement. A 59-year-old man presented with a sudden onset of left flank pain and severe hypertension together with elevated creatinine levels. A computed tomography scan revealed a focal dissection at the left re...

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Veröffentlicht in:Annals of vascular surgery 2014-05, Vol.28 (4), p.1034.e5-1034.e8
Hauptverfasser: García-Familiar, Ainhoa, Ortiz-Gutiérrez, Francisco, De Blas-Bravo, Mariano, Sánchez-Abuín, Javier, Rodríguez Sáenz de Buruaga, Víctor, Egaña-Barrenechea, Jose María
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Sprache:eng
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Zusammenfassung:We report a rare case of isolated spontaneous renal artery dissection treated by stent placement. A 59-year-old man presented with a sudden onset of left flank pain and severe hypertension together with elevated creatinine levels. A computed tomography scan revealed a focal dissection at the left renal artery (LRA) with an infarcted left kidney. Despite medical treatment with 4 drugs, the patient’s blood pressure remained uncontrolled. Angiography confirmed the diagnosis. A 6- × 60-mm Xpert stent (Abbott Vascular, Temecula, CA) was deployed at the LRA, achieving an enlarged true lumen with a patent stent. After the procedure, acute renal impairment was observed but pain subsided and blood pressure normalized under the treatment prescribed. At 12 months of follow-up, the patient was normotensive and asymptomatic with mild chronic renal failure and a patent LRA stent on doppler ultrasonography. The endovascular treatment of isolated spontaneous renal artery dissection appears to be feasible and effective and could be the first-line treatment when revascularization is needed.
ISSN:0890-5096
1615-5947
DOI:10.1016/j.avsg.2013.06.043