Spontaneous Renal Artery Dissection in a Patient with Neurofibromatosis Type I

Abstract

We present a case of spontaneous renal artery dissection (SRAD) in a 28-year-old female with history of neurofibromatosis type I (NF-1) treated successfully with endovascular stenting. The clinical presentation, diagnostic testing, and treatment options are discussed. An endovascular approach with stenting was successfully performed after failure of medical treatment with subcutaneous low molecular weight heparin. Patient's blood pressure and symptoms improved significantly. This may be the first reported case of SRAD in a patient with NF-1 successfully treated with endovascular stenting.

Figure 1

CT angiography of the renal arteries. Transverse view (a) and 3D rendering (b) showing the right renal artery (arrow).

Figure 2

Right renal angiogram showing dissection of the right renal artery (arrow).

Figure 3

Renal artery treatment. (a) 0.014′′ coronary wire crossing the true lumen (arrow), (b) 2 wires, one in the upper lobar branch and one in the lower branch with balloon dilation of the main trunk into the upper branch (white arrow), (c) stenting of the upper branch (white arrow) and the main branch into the lower branch (black arrow), and (d) final image showing the posttreatment results. Dark open arrow points to the infarcted upper lobe of the right kidney where dye opacification is minimal.