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Bilateral spontaneous renal artery dissection.

Tadashi Araki1, Masato Nakamura1, Takaaki Imamura1

  • 1Division of Cardiovascular Medicine, Toho University Ohashi Medical Center, 2-17-6 Ohashi, Meguro-ku, Tokyo 153-8515, Japan.

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|December 8, 2018
PubMed
Summary

Spontaneous renal artery dissection is a rare cause of kidney infarction. This case study details a woman treated conservatively for bilateral renal artery dissection and infarction.

Keywords:
Doppler ultrasonographyFibromuscular dysplasiaIntravascular ultrasoundRenal infarctionSpontaneous renal artery dissection

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Area of Science:

  • Nephrology
  • Vascular Surgery
  • Radiology

Background:

  • Spontaneous renal artery dissection (SRAD) is an uncommon condition.
  • SRAD can lead to renal infarction, a serious complication.
  • This case highlights a rare presentation in a healthy individual.

Purpose of the Study:

  • To report a case of spontaneous bilateral renal artery dissection.
  • To describe the diagnostic imaging findings.
  • To illustrate a successful conservative management approach.

Main Methods:

  • Enhanced abdominal computed tomography (CT) for initial diagnosis.
  • Doppler ultrasonography and selective angiography for detailed vascular assessment.
  • Intravascular ultrasound (IVUS) for precise intimal flap visualization.

Main Results:

  • CT revealed a dissecting intimal flap in the left renal artery, causing renal infarction.
  • Doppler US, angiography, and IVUS confirmed bilateral renal artery dissection with false lumen expansion.
  • The patient experienced an uneventful recovery with conservative treatment.

Conclusions:

  • Spontaneous renal artery dissection can occur bilaterally.
  • A combination of advanced imaging modalities is crucial for diagnosis.
  • Conservative management with anticoagulation and analgesia can be effective.