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Case Reports
. 2007 Summer;9(3):156-60.

Spontaneous renal artery dissection

Jamie A Kanofsky  1 , Herbert Lepor
Affiliations
Case Reports

Spontaneous renal artery dissection

Jamie A Kanofsky et al. Rev Urol. 2007 Summer.

Abstract

Spontaneous renal artery dissection (SRAD) is a rare event, and thus may be a challenge for physicians to diagnose and treat. We report a case of SRAD in a healthy 56-year-old male who presented with flank pain, fever, and elevated white blood cell count. The patient was initially diagnosed with nephrolithiasis versus pyelonephritis and was admitted for observation. Multiple imaging modalities, including non-contrast computed tomography (CT), magnetic resonance imaging (MRI) with gadolinium, CT angiogram, and intraoperative angiogram, were used to make the final diagnosis of SRAD. The patient was treated with endovascular stent placement and is currently free of pain with normal laboratory values and blood pressure.

Keywords: Angiogram; Dissection; Endovascular stenting; Kidney; Renal artery.

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Figures

Figure 1
Figure 1
Non-contrast computed tomography scan showing a small non-obstructing stone in the LLP and perinephric stranding of both kidneys, right greater than left.
Figure 2
Figure 2
(A) Magnetic resonance cholangiopancreatography (MRCP). (B) T1 post contrast MRCP showing right renal cortical and medullary wedge-shaped areas of hypoperfusion with enhancement of the capsule, thought to be most consistent with renal infarction. (C) T1 precontrast MRCP showing patent right renal artery with high signal intensity posterior in the artery, possibly representing dissection.
Figure 3
Figure 3
(A) Computed tomography (CT) with contrast revealing multiple peripheral infarcts in the right kidney with a small amount of fluid/edema in the right perinephric space, slightly increased from previous non-contrast CT. (B) CT angiogram showing a linear filling defect of the right renal artery consistent with dissection and intramural hematoma. (C) CT angiogram once again showing the linear filling defect in the right renal artery, consistent with dissection and intramural hematoma.
Figure 4
Figure 4
(A) Intra-operative angiogram showing right renal artery dissection prior to stent placement. (B) Intra-operative angiogram after placement of a stent in the right renal artery.
See this image and copyright information in PMC

References

    1. Mudrick D, Arepally A, Geschwind JF. Spontaneous renal artery dissection: treatment with coil embolization. J Vasc & Int Rad. 2003;14(4):497–500. - PubMed
    1. Ramamoorthy SL, Vasquez JC, Taft PN. Nonoperative management of acute spontaneous renal artery dissection. Annals of Vasc Surg. 2002;16(2):157–162. - PubMed
    1. Beroniade V, Roy P, Froment D, Pison C. Primary renal artery dissection: presentation of two cases and brief review of the literature. Am J Nephrol. 1987;7:382–389. - PubMed
    1. LaCombe M. Isolated spontaneous dissection of the renal artery. J Vasc Surg. 2001;33:385–391. - PubMed
    1. Slavis SA, Hodge EE, Novick AC, Maatman T. Surgical treatment for isolated dissection of the renal artery. J Urol. 1990;144(2 Pt 1):233–237. - PubMed

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