A Case of Spontaneous Renal Artery Dissection with Renal Infarction in a Healthy Man Without Hypertension / 대한신장학회잡지

It is usually known that arterial dissection is associated with malignant hypertension, severe atherosclerosis or trauma. Marfan syndrome or Ehlers- Danlos syndrome may also be rare causes. However, as in this case, spontaneous arterial dissection without aortic dissection in normotensive men is rarely reported. A 39-year-old man presented with acute onset right flank pain with microscopic hematuria. Physical examination was unremarkable and his blood pressure was normal. Clinical impression was urolithiasis because he experienced two episodes of urolithiasis previously. IVP was not completed due to adverse reaction during study. Right renal infarction was diagnosed by contrast-enhanced computed tomography. To search for possible cardiac embolic disease, the patient underwent surface echocardiography, which was normal and a detailed evaluation for a thrombotic tendency was unremarkable. A renal arteriogram showed dissection of the main right renal artery with extension to renal artery branches and a wedge-shape perfusion defect in the distal part of the occluded artery. He received aorto-renal bypass surgery using his great saphenous vein. The patient developed hypertension 3 months later. To summary, we report a case of spontaneous renal artery dissection with renal infarction in a healthy man without hypertension.

Aortorenal Bypass with Saphenous Vein in the Patient of Left Renal Arterial Stenosis and Right Renal Hypoplasia / 대한비뇨기과학회지

Renal hypertension is found to be the cause in 5-15% of patients with hypertension, and may be vascular or renal parenchymal in nature. Recent advances in diagnostic technique and vascular reconstructive techniques now enable successful management in many patients with renal hypertension. We observed one case of renovascular hypertension due to right renal hypoplasia and left renal arterial stenosis, in 22 year-old female patient with complaints of headache and dizziness for 10 days. The treatment was done by right nephrectomy and left aortorenal bypass procedure with saphenous vin. Herein we reported a case of renovascular hypertension with a review of the literatures.