Spontaneous isolated dissection at renal upper abdominal aortic: a rare case report

Arterial dissection is defined as a cleavage of the arterial wall caused by intramural hematoma. Isolated extra-aortic arterial dissection has been reported in renal and carotid arteries in few literatures but suprarenal aorta dissection associated with retrograde formation of a giant descending thoracic aneurysm is considered very rare. We present a quite unusual case of suprarenal aorta dissection associated with retrograde formation of a giant descending thoracic aneurysm sparing both renal and mesenteric vessels, without any branch vessel involvement or visceral damage. Because of the patient's persistent epigastric pain, endovascular celiac artery stent implantation was performed with 3 multiple overlapping uncovered stents. Twelve months after the procedure, computed tomographic angiography (CTA) of the abdomen showed patency of both celiac stents with thrombus formation in the retrograde dissection sac, and the patient remained asymptomatic. This case and others in the medical literature suggest that endovascular treatment can be feasible in symptomatic patients with spontaneous isolated dissection at renal upper abdominal aortic.