A Case of Spontaneous Renal Artery Dissection Secondary to Fibromuscular Dysplasia and Treatment by Renal Arterial Stenting.
- Author:
Hyunjeong BAEK
1
;
Dae Joong KIM
;
Hyun Joo SUH
;
Min Ok KIM
;
Ho Myoung YEO
;
Jung Ah KIM
;
Hyun Jin KIM
;
Woo Heon KANG
;
Beom KIM
;
Wooseong HUH
;
Yoon Goo KIM
;
Ha Young OH
;
Young Soo DO
Author Information
1. Department of Medicine, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul, Korea. kimdjmed@dreamwiz.com
- Publication Type:Case Report
- Keywords:
Spontaneous renal artery dissection;
Fibromuscular dysplasia;
Stent implantation
- MeSH:
Abdomen;
Angiography;
Angioplasty, Balloon;
Blood Pressure;
Constriction, Pathologic;
Creatinine;
Emergency Service, Hospital;
Fibromuscular Dysplasia*;
Flank Pain;
Heparin;
Humans;
Hypertension;
Infarction;
Male;
Middle Aged;
Recurrence;
Renal Artery*;
Stents*;
Tomography, X-Ray Computed;
Warfarin
- From:Korean Journal of Nephrology
2004;23(5):815-819
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
Isolated spontaneous renal artery dissection (SRAD) associated with fibromuscular dysplasia (FMD) is a rare condition that can result in renal infarction. Treatment and long-term management of patients with this condition is controversial. We report the case of a patient with SRAD secondary to FMD who was treated by renal arterial stenting. A previous healthy 50-year-old white male presented to the emergency department with acute right flank pain. Blood pressure was 150/90 mmHg and serum creatinine was 1.6 mg/dL. A CT scan of the abdomen showed multifocal right renal infarction. The patient was started on anticoagulant regimen of heparin. Renal angiography showed the dissection of right renal artery and stenosis of mid-segment of right main renal artery and intrarenal branches. We decided to perform percutaneous balloon angioplasty and stenting for the purpose of dilating the stenotic renal artery, preventing recurrence of the disease and controlling hypertension and elevated creatinine. A dissected intimal flap was closed successfully by renal artery stenting and stenotic renal artery was dilated by stenting and balloon angioplasty. Five days after the procedure, he was discharged with warfarin. Three months later, he had normal renal function and blood pressure without antihypertensive medication was mildly elevated at 145/104 mmHg. Conclusively, stent implantation to renal artery dissection can be effective, reliable and feasible and can be an alternative to surgical treatment.
