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Ann Vasc Surg ; 28(4): 1034.e5-8, 2014 May.
Article in English | MEDLINE | ID: mdl-24211411

ABSTRACT

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.


Subject(s)
Aortic Dissection/therapy , Endovascular Procedures/instrumentation , Renal Artery , Stents , Aortic Dissection/diagnosis , Aortic Dissection/physiopathology , Antihypertensive Agents/therapeutic use , Blood Pressure , Humans , Hypertension, Renovascular/diagnosis , Hypertension, Renovascular/drug therapy , Hypertension, Renovascular/physiopathology , Infarction/diagnosis , Infarction/therapy , Kidney Failure, Chronic/diagnosis , Kidney Failure, Chronic/physiopathology , Kidney Failure, Chronic/therapy , Male , Middle Aged , Renal Artery/diagnostic imaging , Renal Artery/physiopathology , Tomography, X-Ray Computed , Treatment Outcome
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