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Endovascular management of renal ischemia in a patient with acute aortic dissection and renovascular hypertension.

Abstract：

:We report the endovascular management of a patient with a type B aortic dissection complicated by renal ischemia and resultant severe hypertension. A 69-year-old male presented with acute type B aortic dissection with proximal extension complicated by severe renovascular hypertension secondary to left renal ischemia. Endovascular management consisted of imaging with intravascular ultrasound and left renal artery stenting with balloon-expandable stents. His hypertension subsequently resolved and he was discharged on his baseline two-drug regimen. Management of the ischemic complications of type B aortic dissections may be primarily approached using endovascular methods in stable patients, with open surgery reserved for those patients refractory to these methods. Patients with evidence of decreased renal perfusion represent a select group with an increased risk of associated morbidity and mortality and should therefore be aggressively managed. Accurate information and assessment of anatomy can be obtained with intravascular ultrasound and is therefore an important adjunct to the armamentarium of endovascular specialists managing complications of aortic dissection.

journal_name

Ann Vasc Surg

journal_title

Annals of vascular surgery

authors

Starnes BW,O'Donnell SD,Gillespie DL,Goff JM,Rosa P,Rich NM

doi

10.1007/s10016-001-0184-7

subject

Has Abstract

pub_date

2002-05-01 00:00:00

pages

368-74

issue

3

eissn

0890-5096

issn

1615-5947

pii

S0890-5096(06)62290-5

journal_volume

16

pub_type

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