Introduction.

Spontaneous Renal Artery Dissection (SRAD) is a rare and often unrecognized clinical entity, which only accounts for 1-2% of all arterial dissections. Due to its rarity, it may be difficult to diagnose and treat.

Methods.

All patients affected by SRAD and admitted in our Unit in the last year were included.

Results.

Five patients presented with renal infarction due to SRAD were admitted in our Unit in 2020. Patient Characheristics are shown in Table 1. At onset, all suffered from abdominal pain and high blood pressure. In all patients renal function was normal. Abdomen computed tomography angiography (CTA) was diagnostic in all patients (Figure 1). They were treated with antihypertensive drugs and systemic anticoagulation followed by oral anticoagulants. At 3 month-follow-up, all patients became normotensive and partial or total renal artery recanalization were found (Figure 2).

Abdominal CTA of 4 patients with SRAD at onset
MO173   Figure 1:

Abdominal CTA of 4 patients with SRAD at onset

Abdominal CTA of 4 patients with SRAD after therapy
MO173   Figure 2:

Abdominal CTA of 4 patients with SRAD after therapy

MO173   Table 1.

Patient Characteristics at onset.

PatientSexAge (years)Blood Pressure (mmHg)SRADComobiditiesCerebral MRI/CT
1F61150/100Left segmental branch anterior inferior and Right renal arteryKidney stonesnegative
2M49150/90Right renal arterySevere cardiovascular familiarity, GISTnegative
3M39140/90Left segmental antero-inferior renal arterySevere cardiovascular familiarity, OFP ostium IInegative
4F51145/85Left renal arteryDolicocolonCarotid-oftalmic aneurism
5M50150/100Right and left renal arteryFamily history for tumorsnegative
PatientSexAge (years)Blood Pressure (mmHg)SRADComobiditiesCerebral MRI/CT
1F61150/100Left segmental branch anterior inferior and Right renal arteryKidney stonesnegative
2M49150/90Right renal arterySevere cardiovascular familiarity, GISTnegative
3M39140/90Left segmental antero-inferior renal arterySevere cardiovascular familiarity, OFP ostium IInegative
4F51145/85Left renal arteryDolicocolonCarotid-oftalmic aneurism
5M50150/100Right and left renal arteryFamily history for tumorsnegative
MO173   Table 1.

Patient Characteristics at onset.

PatientSexAge (years)Blood Pressure (mmHg)SRADComobiditiesCerebral MRI/CT
1F61150/100Left segmental branch anterior inferior and Right renal arteryKidney stonesnegative
2M49150/90Right renal arterySevere cardiovascular familiarity, GISTnegative
3M39140/90Left segmental antero-inferior renal arterySevere cardiovascular familiarity, OFP ostium IInegative
4F51145/85Left renal arteryDolicocolonCarotid-oftalmic aneurism
5M50150/100Right and left renal arteryFamily history for tumorsnegative
PatientSexAge (years)Blood Pressure (mmHg)SRADComobiditiesCerebral MRI/CT
1F61150/100Left segmental branch anterior inferior and Right renal arteryKidney stonesnegative
2M49150/90Right renal arterySevere cardiovascular familiarity, GISTnegative
3M39140/90Left segmental antero-inferior renal arterySevere cardiovascular familiarity, OFP ostium IInegative
4F51145/85Left renal arteryDolicocolonCarotid-oftalmic aneurism
5M50150/100Right and left renal arteryFamily history for tumorsnegative
Conclusions.

In our experience, SRAD seems to be not very rare in young and healthy patients with minimal comorbidities. Abdomen CTA is one of the “gold standard” non invasive diagnostic method. In patient treated with conservative medical therapy renal outcome is favourable. More studies are necessary to find underlying causes.

Close
This Feature Is Available To Subscribers Only

Sign In or Create an Account

Close

This PDF is available to Subscribers Only

View Article Abstract & Purchase Options

For full access to this pdf, sign in to an existing account, or purchase an annual subscription.

Close