Evaluation of characteristics, associations and clinical course of isolated spontaneous renal artery dissection

Afshinnia, Farsad; Sundaram, Baskaran; Rao, Panduranga S.; Stanley, James C.; Bitzer, Markus

doi:10.1093/ndt/gft073

Cited by 39 publications

(50 citation statements)

References 43 publications

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“…The exact pathogenesis remains unclear but is thought to be secondary to bleeding from vasa vasorum leading to intramural haemorrhage or blood dissecting through a primary intimal tear 6. On Laboratory evaluation, patients are frequently found to have increased creatinine values, leucocytosis and elevated serum LDH levels, suggesting renal parenchymal loss 7. Renal arterial dissection results in haematoma formation between the intima and medial layers often resulting in severe stenosis leading to renal ischaemia, elevated renin secretion and consequent uncontrolled hypertension 5.…”

Section: Discussionmentioning

confidence: 99%

Spontaneous renal artery dissection masquerading as urinary tract infection

2018

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Spontaneous renal artery dissection is a rare clinical entity, and symptoms vary from non-specific abdominal pain to life-threatening hypertension. A 44-year-old woman with no significant medical history initially presented with symptoms suggestive of urinary tract infection which did not respond to antibiotic therapy. Imaging revealed right renal infarction resulting from focal spontaneous renal artery dissection, which was managed conservatively. CT angiography is the preferred imaging modality for the diagnosis of this condition. Treatment options include medical management of hypertension with or without anticoagulation, endovascular intervention and surgical revascularisation depending on the presentation and the extent of the vascular and renal parenchymal involvement. This case emphasises the need to have high index of suspicion for uncommon diagnoses in patients who present with common symptoms but do not respond to empiric therapy.

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Section: Discussionmentioning

confidence: 99%

Spontaneous renal artery dissection masquerading as urinary tract infection

2018

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“…20 Nail-Patella syndrome, along with other connective tissue disorders, may contribute to the development of spontaneous renal artery dissection. 21 Clinical presentation of SCAD includes chest pain, dyspnea, cardiac arrhythmia, cardiac arrest or sudden death. Given the vague nature of cardiovascular warning signs such as chest pain, heartburn, and shortness of breath that may mimic normal pregnancy complaints, clinicians should remain vigilant.…”

Section: Discussionmentioning

confidence: 99%

Spontaneous coronary artery dissection in a parturient with Nail–Patella syndrome

Nizamuddin

Broderick

Minehart

et al. 2015

International Journal of Obstetric Anesthesia

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“…Arterial dissections are frequent in malignant hypertension, atherosclerosis, trauma, fibromuscular dysplasia, connective tissue diseases such as Marfan syndrome, Ehler-Danlos syndrome (20)(21)(22). Cocaine abuse and extracorporeal shock wave lithotripsy cases were also reported (22).…”

Section: Renal Vascular Pathologiesmentioning

confidence: 99%

“…Cocaine abuse and extracorporeal shock wave lithotripsy cases were also reported (22). The most common localization of primary dissection of perinephric arteries is renal arteries (20).…”

Section: Renal Vascular Pathologiesmentioning

confidence: 99%

“…Because of this, even if there is no history of trauma in a patient with acute flank pain and hypertension, isolated renal artery dissection may also be taken into consideration (20,25). Angiography with catheter is a gold standard in diagnosis; however, it is possible to evaluate by CT angiography noninvasively (22,25). In CT renal perfusion defects, areas without contrast enhancement and hypodense image in renal artery may be seen ( Figure 6).…”

Section: Renal Vascular Pathologiesmentioning

confidence: 99%

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