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International Scientific Indexing (ISI) Indexed Journal Applied Medical Research ISSN: 2149 - 2018
Applied Medical Research. 2021; 8(2):(116-159)

Acute Renal Infarcts from Spontaneous Intra-Renal Dissection: Case Series with a Review of Literature

Karan Daga, Benjamin SY Chua and Manish Taneja

Introduction: To explore the causes and management of renal infarction from pathologies such as renal artery fibromuscular dysplasia and spontaneous dissection. It is a rare occurrence and often misdiagnosed in clinical practice. Methods: We present four patients, between 30-50 years of age, who have no underlying cardiac conditions, hypertension or diabetes mellitus. They presented with abdominal/loin/flank pain due to spontaneous renal artery dissection and were treated with endovascular stents. Two patients had renal artery fibromuscular dysplasia, confirmed by CT angiogram. Results: All four patients recovered fully from the operation, with no post-operative complications noted. These patients were post-operatively managed medically with anti- platelet therapy for two years and have not experience any post-procedural complications at their 24-month follow up. Conclusion: Classically visceral artery dissection can be managed by antiplatelet therapy alone, however fibromuscular dysplasia can cause spontaneous dissection with renal infarcts and this requires urgent treatment with endovascular stents. Further research is needed on the post-procedural medical management guidelines. Advances in Knowledge: Renal artery fibromuscular dysplasia is a rare pathology which is commonly reported in literature to affect in females, whereas we present four young male patients. Additionally, all patients were treated with endovascular stents, as opposed to angioplasty.