Isolated Renal Artery Dissection: A Systematic Review of Case Reports

Jha, Anil; Afari, Maxwell Eyram; Koulouridis, Ioannis; Bhat, Tariq; García, L. Grimalt

doi:10.7759/cureus.6960

Cited by 7 publications

(7 citation statements)

References 14 publications

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“…(4)(5)(6) In chronic cases, complaints related to difficult-tocontrol hypertension are reported and gastrointestinal and urinary symptoms that can mimic other diseases, making the diagnosis difficult. (7) The rarity of the disease and the non-specificity of symptoms highlight the importance of identifying risk factors, such as fibromuscular dysplasia, strenuous exercise, use of cocaine, among others, for quickest investigation of this disease. In this case report, the patient had a history of intense physical exercise in the previous days, which may have been a triggering factor for the condition.…”

Section: ❚ Discussionmentioning

confidence: 99%

“…(8) Other diagnostic methods that can be used are intravascular ultrasonography and optical coherence tomography (OCT), which provide a detailed assessment of the vessel wall. (7) In case of high clinical suspicion and impairment of renal function, the investigation should be performed initially with ultrasonography, (8) followed by arteriography, in doubtful cases or with a therapeutic objective.…”

Section: ❚ Discussionmentioning

confidence: 99%

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Spontaneous renal artery dissection: angioplasty with stent implantation in one-year follow-up

Souza

Falsarella

Nasser

et al. 2022

Einstein (São Paulo)

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Spontaneous renal artery dissection is an unusual and idiopathic condition in most cases. In young, mildly symptomatic patients, diagnosis may be difficult, frequently culminating in delay in treatment. This report presents the case of a 40-year-old male patient, with severe hypertension of sudden onset, and difficult management of oral medication. In etiological investigation, Echo-Doppler of renal arteries showed signs of hemodynamically relevant right renal artery stenosis. Arteriography showed presence of double-lumen and thrombus in the vessel lumen, indicating dissection. The proposed treatment was endovascular approach after failure of isolated medical treatment, option which included the aspiration of the thrombus by Penumbra System ® device and balloon angioplasty, followed by right renal artery stenting. Improvement of immediate sonographic control of peak systolic velocity and renal-aortic ratio was shown, with a consequent reduction of systemic arterial blood pressure and stabilization of renal function. Within the following year, the patient presented in-stent stenosis and was successfully treated with balloon angioplasty.

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Section: ❚ Discussionmentioning

confidence: 99%

Section: ❚ Discussionmentioning

confidence: 99%

Spontaneous renal artery dissection: angioplasty with stent implantation in one-year follow-up

Souza

Falsarella

Nasser

et al. 2022

Einstein (São Paulo)

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“…dissections and visceral artery dissections (256). Unlike many other types of dissections, the presence of atherosclerosis is not considered a basis to exclude spontaneous arterial dissection in renal or visceral dissection diagnosis (257,258).…”

Section: Renal and Visceral Artery Dissectionsmentioning

confidence: 99%

“…Likewise, mesenteric and splenic artery dissections occur much more commonly in men (>80% of cases) ( 254 , 255 ). Hypertension is linked to renal dissections and visceral artery dissections ( 256 ). Unlike many other types of dissections, the presence of atherosclerosis is not considered a basis to exclude spontaneous arterial dissection in renal or visceral dissection diagnosis ( 257 , 258 ).…”

Section: Spontaneous Arterial Dissectionsmentioning

confidence: 99%

Arterial dissections: Common features and new perspectives

Bax

Romanov

Junday

et al. 2022

Front. Cardiovasc. Med.

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Arterial dissections, which involve an abrupt tear in the wall of a major artery resulting in the intramural accumulation of blood, are a family of catastrophic disorders causing major, potentially fatal sequelae. Involving diverse vascular beds, including the aorta or coronary, cervical, pulmonary, and visceral arteries, each type of dissection is devastating in its own way. Traditionally they have been studied in isolation, rather than collectively, owing largely to the distinct clinical consequences of dissections in different anatomical locations – such as stroke, myocardial infarction, and renal failure. Here, we review the shared and unique features of these arteriopathies to provide a better understanding of this family of disorders. Arterial dissections occur commonly in the young to middle-aged, and often in conjunction with hypertension and/or migraine; the latter suggesting they are part of a generalized vasculopathy. Genetic studies as well as cellular and molecular investigations of arterial dissections reveal striking similarities between dissection types, particularly their pathophysiology, which includes the presence or absence of an intimal tear and vasa vasorum dysfunction as a cause of intramural hemorrhage. Pathway perturbations common to all types of dissections include disruption of TGF-β signaling, the extracellular matrix, the cytoskeleton or metabolism, as evidenced by the finding of mutations in critical genes regulating these processes, including LRP1, collagen genes, fibrillin and TGF-β receptors, or their coupled pathways. Perturbances in these connected signaling pathways contribute to phenotype switching in endothelial and vascular smooth muscle cells of the affected artery, in which their physiological quiescent state is lost and replaced by a proliferative activated phenotype. Of interest, dissections in various anatomical locations are associated with distinct sex and age predilections, suggesting involvement of gene and environment interactions in disease pathogenesis. Importantly, these cellular mechanisms are potentially therapeutically targetable. Consideration of arterial dissections as a collective pathology allows insight from the better characterized dissection types, such as that involving the thoracic aorta, to be leveraged to inform the less common forms of dissections, including the potential to apply known therapeutic interventions already clinically available for the former.

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“…Dieses kann thrombosieren und embolisieren, was bei 8-11 % der Nierenarterienaneurysmen (NAA) auftritt [2]. Diagnostik der Wahl ist die CTA oder Magnetresonanzangiographie (MRA; [3]). Zur besseren Darstellbarkeit wird in ausgewählten Fäl-len die selektive Angiographie empfohlen [2].…”

Section: Antikoagulation Und Einer Intervention Wird Individuell Abgewogenunclassified

Niereninfarkt seltener Ursache bei einem 28-jährigen Patienten

2021

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Es wird über den Fall eines 28-jährigen Patienten mit einem Niereninfarkt aufgrund eines embolisierenden Aneurysmas nach traumatischer Dissektion einer Nierensegmentarterie berichtet. Er stellte sich 1,5 Jahre nach einem Motorradunfall mit Abdominal-und Flankenschmerzen vor. C-reaktives Protein und Laktat-Dehydrogenase waren erhöht. Die Diagnose wurde mittels computertomographischer Angiographie gestellt. Weitere Ursachen eines Niereninfarkts wurden ausgeschlossen. Nach interdisziplinärer Besprechung entschieden wir uns bei jungem und sportlich aktivem Patienten für ein interventionelles Coiling, um eine langfristige Antikoagulation zu vermeiden.

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Isolated Renal Artery Dissection: A Systematic Review of Case Reports

Cited by 7 publications

References 14 publications

Spontaneous renal artery dissection: angioplasty with stent implantation in one-year follow-up

Spontaneous renal artery dissection: angioplasty with stent implantation in one-year follow-up

Arterial dissections: Common features and new perspectives

Niereninfarkt seltener Ursache bei einem 28-jährigen Patienten

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