title: Isolated spontaneous renal artery dissection: endovascular management.
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.
authors.affiliation: Department of Vascular Surgery, Donostia University Hospital, San Sebastián, Spain. Electronic address: nhoa_ai@hotmail.com.
authors.forename: Ainhoa
authors.initials: A
authors.lastname: García-Familiar
authors.affiliation: Department of Vascular Surgery, Donostia University Hospital, San Sebastián, Spain.
authors.forename: Francisco
authors.initials: F
authors.lastname: Ortiz-Gutiérrez
authors.affiliation: Department of Interventional Radiology, Donostia University Hospital, San Sebastian, Spain.
authors.forename: Mariano
authors.initials: M
authors.lastname: De Blas-Bravo
authors.affiliation: Department of Vascular Surgery, Donostia University Hospital, San Sebastián, Spain.
authors.forename: Javier
authors.initials: J
authors.lastname: Sánchez-Abuín
authors.affiliation: Department of Vascular Surgery, Donostia University Hospital, San Sebastián, Spain.
authors.forename: Víctor
authors.initials: V
authors.lastname: Rodríguez Sáenz de Buruaga
authors.affiliation: Department of Vascular Surgery, Donostia University Hospital, San Sebastián, Spain.
authors.forename: Jose María
authors.initials: JM
authors.lastname: Egaña-Barrenechea
mesh_terms: D000784:Aortic Dissection / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy*; D000959:Antihypertensive Agents / Q000627:therapeutic use; D001794:Blood Pressure; D057510:Endovascular Procedures / Q000295:instrumentation*; D006801:Humans; D006978:Hypertension, Renovascular / Q000175:diagnosis / Q000188:drug therapy / Q000503:physiopathology; D007238:Infarction / Q000175:diagnosis / Q000628:therapy; D007676:Kidney Failure, Chronic / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy; D008297:Male; D008875:Middle Aged; D012077:Renal Artery / Q000000981:diagnostic imaging / Q000503:physiopathology; D015607:Stents; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
chemical_list: D000959:Antihypertensive Agents