Applied Medical Research. 2021;
8(2):(116-176)
Acute Renal Infarcts from Spontaneous Intra-Renal Dissection: Case Series with a Review of Literature
Karan Daga, Benjamin SY Chua and Manish Taneja
Abstract
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.
