Extracorporeal repair of primary renal artery dissection

Four cases of isolated dissection of the renal artery were diagnosed and treated in our institution. In 2 cases, angiography showed dissection of the left renal artery with involvement of peripheral branches; in 1 case, the dissection involved the right renal artery with complete occlusion of an upper-pole branch and upper-pole infarction, and 1 patient presented a bilateral dissection, limited to the main trunk on the right side and involving prepelvic and retropelvic branches on the left side. Surgical treatment consisted in renal autotransplantation in the iliac fossa after extracorporeal reconstruction of the arterial pedicle. The results were encouraging with normalization of blood pressure and improvement of renal function in all cases.