Spontaneous Renal Artery Dissection in a Patient with Contralateral Renal Artery Stenosis: Treatment with Percutaneous Endovascular Stent Placement

自發性腎動脈剝離合併對側腎動脈狹窄：經皮血管內支架置放術治療

許榮城(Jung-Cheng Hsu) ； 王禎煜(Jen-Yu Wang) ； 高憲立(Hsien-Li Kao) ； 呂佳虹(Chia-Hung Lu) ； 劉高郎(Kao-Lang Liu) ； 林俊立(Jiunn-Lee Lin)

《Acta Cardiologica Sinica》 21卷4期 (2005/12) Pp. 229-233

摘要

我們報告一個三十六歲血壓控制不良的男病患，最近血壓有急速的惡化和顯著的上升。同時在病患的右上腹部可以聽到血管嘈音，高度懷疑是腎血管高血壓。電腦斷層檢查懷疑有自發性的右腎動脈剝離和對側的腎臟血管狹窄，而後經由傳統血管攝影術證實。經由成功地實行經皮血管內介入術，病患有顯著的臨床改善。臨床上，在頑強性高血壓的病人，腎血管高血壓必須被考慮在內。對於腎血管狹窄或剝離，可經由經皮血管內介入術，來達到更佳的血壓控制，甚至於治癒高血壓。

關鍵字

續發性高血壓 ； 腎臟血管剝離 ； 經皮血管重建術

並列摘要

We report a 36-year-old man with poorly controlled hypertension, who suffered from acute deterioration and marked elevation of blood pressure. Abdominal bruit was heard in the right epigastric area. Renovascular hypertension was highly suspected. Spontaneous right renal artery dissection superimposing contralateral renal artery stenosis was found by computed tomography, and confirmed by conventional angiography. Percutaneous endovascular intervention was done successfully, with dramatic clinical improvement. Renovascular hypertension must be considered in patients with refractory hypertension. Better control of blood pressure, or even cure of hypertension, can be achieved with percutaneous endovascular intervention both in stenosis and dissection of renal arteries.

並列關鍵字

Secondary hypertension ； Renal artery dissection ； Percutaneous endovascular revascularization