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Case Reports
. 2018 Jan 11;13(2):495-498.
doi: 10.1016/j.radcr.2017.11.017. eCollection 2018 Apr.

Segmental arterial mediolysis presenting as spontaneous bilateral renal artery dissection

Nirmal K Onteddu  1 , Zakaria Hindi  1 , Gaurav Rajashekar  1 , Sanjeeva P Kalva  2
Affiliations
Case Reports

Segmental arterial mediolysis presenting as spontaneous bilateral renal artery dissection

Nirmal K Onteddu et al. Radiol Case Rep. .

Abstract

The commonest site of primary dissection involving the visceral vessels is renal arteries; however, spontaneous bilateral renal artery dissection is an extremely rare entity. Spontaneous renal artery dissection (SRAD) is rarely a cause of renovascular hypertension. Segmental arterial mediolysis is a rare arteriopathy of unknown etiology which is a nonatherosclerotic and noninflammatory condition. We report a case of a 51-year-old male patient with spontaneous dissection of bilateral renal arteries with clinical, laboratory, and angiographic findings consistent with segmental artery mediolysis. Early diagnosis and treatment of this condition will decrease morbidity and mortality.

Keywords: Dissection; Renal hypertension; Segmental arterial mediolysis.

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Figures

Fig. 1
Fig. 1
Color Doppler ultrasound shows lack of vascularity within the hypoechoic region in the middle lower pole of the left kidney.
Fig. 2
Fig. 2
Contrast-enhanced magnetic resonance angiography shows focal diffuse dilatation of right main renal artery, distal tapering of inferior accessory right renal artery, and irregularity and dissection of left main renal artery.
Fig. 3
Fig. 3
Left renal angiography shows focal dissection of left main renal artery with dilated false lumen. Also note diffuse narrowing of lower pole branch vessel secondary to dissection extending into the lower pole branch resulting in an infarct seen on magnetic resonance imaging.
Fig. 4
Fig. 4
Right renal arteriogram shows diffuse fusiform dilation of mid segment of right main renal artery.
See this image and copyright information in PMC

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