[Pickering syndrome: acute heart failure with an unexpected actor]

Area of Science:

• Nephrology
• Cardiology
• Vascular Surgery

Background:

• Pickering syndrome presents as recurrent, nocturnal pulmonary edema and hypertension.
• It is typically secondary to renal artery stenosis in both kidneys or a single kidney.

Observation:

• A 74-year-old man developed Pickering syndrome after endovascular aortic aneurysm repair.
• The syndrome was caused by left renal artery obstruction from the aortic endoprosthesis.

Findings:

• The patient experienced acute flash pulmonary edema and severe hypertension.
• Revascularization of the left renal artery led to a satisfactory clinical recovery.

Implications:

• This case underscores the importance of monitoring renal artery flow after aortic endoprosthesis placement.
• Early diagnosis and intervention, such as revascularization, are crucial for managing Pickering syndrome.
• Endovascular aortic aneurysm repair can precipitate rare complications like Pickering syndrome.