Spontaneous renal artery dissection: long-term outcomes after endovascular stent placement.

PURPOSE: To report long-term clinical and morphologic results after stent placement for spontaneous renal artery dissection (SRAD).

MATERIALS AND

METHODS

Between 1991 and 2006, 16 consecutive patients (13 men; mean age, 42 y +/- 12) presented with SRAD in 17 arteries. All patients had uncontrolled hypertension at the time of presentation. Nine patients had lower back pain, 10 had progressive renal insufficiency, and three had both. All patients underwent renal angiography and stent implantation. They were followed up clinically and with renal imaging.

RESULTS

Baseline blood pressure and plasma creatinine levels were 176/107 mm Hg and 142 micromol/L, respectively. Successful renal artery recanalization and stent implantation were achieved in all patients. After a mean follow-up of 8.6 years +/- 3.4, mean blood pressure was 118/78 mm Hg, with Seven patients were taking no antihypertensive medication, with five and four patients taking single or double antihypertensive agents, respectively. The most recent follow-up showed that plasma creatinine levels were normal, and imaging of the renal arteries showed no sign of restenosis or occlusion in all patients.

CONCLUSIONS

Stent implantation for symptomatic SRAD is an effective treatment in the long term and represents a safe alternative to surgery.