ABSTRACT
Organ malperfusion most commonly occurs in the acute stage of aortic dissection and is associated with a high mortality, but can occur with chronic dissection. We describe a case of a type 3 aortic dissection, which had a stenosed left renal artery originating from the false lumen and causing resistant hypertension. The left renal artery was successfully dilated and stented, with prompt resolution of the patient's hypertension.
Subject(s)
Aortic Aneurysm, Abdominal/surgery , Aortic Dissection/surgery , Renal Artery Obstruction/surgery , Stents , Aortic Dissection/complications , Aortic Dissection/diagnosis , Angiography, Digital Subtraction , Aortic Aneurysm, Abdominal/complications , Aortic Aneurysm, Abdominal/diagnosis , Blood Vessel Prosthesis Implantation , Cardiac Catheterization , Chronic Disease , Humans , Hypertension, Renal/diagnosis , Hypertension, Renal/etiology , Hypertension, Renal/surgery , Magnetic Resonance Angiography , Male , Middle Aged , Renal Artery Obstruction/complications , Renal Artery Obstruction/diagnosisABSTRACT
This is a case of a 65-year-old woman with a history of coronary artery disease, who presented with hypertension that was poorly controlled by medical treatment. A rotational abdominal aortogram was done, followed by selective right and left renal artery angiograms. Imaging of renal artery aneurysms can be tricky, and some aneurysms might be misdiagnosed for a tortuous renal artery. In such cases, the physician needs to maintain a high index of suspicion towards this condition. Three-dimensional reconstruction allows for a better visualization of the aneurysm and its surrounding structures. It also guides the operator to the projection that best reveals the anatomical criteria of the aneurysm.
