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Spontaneous renal artery dissection is a rare condition with an often non-specific presentation, resulting in a challenging diagnosis for clinicians. This is the case of a 39-year-old man who presented with an acute-onset right flank pain, mild neutrophilia and sterile urine. CT of abdomen and pelvis showed a patchy hypodense area in the right kidney originally thought to represent infection. He was treated as an atypical pyelonephritis with antibiotics and fluids. When his symptoms failed to improve, a diagnosis of renal infarction was considered and CT angiogram of the aorta revealed a spontaneous renal artery dissection. He was managed conservatively with systemic anticoagulation, antihypertensive treatment and analgesia and discharged home with resolution of his symptoms and normal renal function.

INTRODUCTION Renal sympathetic denervation (RSDN) is an alternate management approach for refractory ventricular arrhythmias (VAs). We aimed to perform a systematic review of clinical outcomes on the impact of RSDN on refractory VA patients. METHODS A systematic search without language restriction, using PubMed, EMBASE, SCOPUS, Google Scholar, and ClinicalTrials.gov from inception to August 18, 2020, was performed for the studies that reported outcomes in patients who underwent RSDN for VA. The outcomes studied were-(1) recurrent VA; and (2) all-cause mortality. RESULTS Five studies (from 2014 to 2018) with a total of 51 VA patients met study inclusion criteria. The mean age was 61.92 ± 11.76 years, and 78.4% were men. The pooled incidence of short-term (3 months or less) and long-term (more than 3 months) VA recurrence was 63.85% (95% CI 16.75 to 99.32) and 10.52% (95% CI 0.14 to 28.75), respectively. When stratified by the number of VA episodes, there was a significant reduction in mean VA episodes (SMD -3.79, 95% CI -6.59 to -0.98, p

Stent-graft placement is an important treatment for traumatic renal artery dissection, but it may occasionally be technically difficult to advance a catheter through the lesion of the dissection due to severe stenosis of the true rumen. A triple-coaxial (triaxial) system, which consists of a small microcatheter, a large microcatheter, and a 4-Fr. catheter, has recently become available, and it contributes to super-selective catheterization. We thought this system may be useful for passing catheters through the dissection. We herein report a 30-year-old male patient with traumatic renal artery dissection, who was successfully treated by stent-graft placement using the triaxial system.

Spontaneous renal artery dissection (SRAD) causing bilateral renal infarction is a rare condition. It may present with nonspecific symptoms, resulting in delayed diagnosis. We report a case of SRAD in an adult male who presented with flank pain and fever. The patient was initially worked up for possible pyelonephritis, which came back negative. Later, a diagnosis of SRAD with bilateral renal infarction was made on contrast-enhanced computed tomography (CT) abdomen followed by CT angiogram. The patient was treated with rivaroxaban and antihypertensive therapy. He was followed up for 12 months after the initial presentation and repeat imaging showed no new infarcts and a stable renal function.

Renal infarction and renal artery dissection are rare and understudied entities whose management remains largely based on expert opinion and local experience. In 2018, Faucon et al had already shed light on the nosology, tentative management, and follow-up of renal infarction based on a large retrospective study including 186 patients. In this issue of Hypertension, they provide new insights, this time focusing on a subgroup of 61 patients without known underlying vascular disease in whom renal infarction was due to spontaneous renal artery dissection. [...]

Introduction. Spontaneous Renal Artery Dissection (SRAD) is a rare and often unrecognized clinical entity, which only accounts for 1-2% of all arterial dissections. Due to its rarity, it may be difficult to diagnose and treat. Methods. All patients affected by SRAD and admitted in our Unit in the last year were included. Results. Five patients presented with renal infarction due to SRAD were admitted in our Unit in 2020. Patient Characheristics are shown in Table 1. At onset, all suffered from abdominal pain and high blood pressure. In all patients renal function was normal. Abdomen computed tomography angiography (CTA) was diagnostic in all patients (Figure 1). They were treated with antihypertensive drugs and systemic anticoagulation followed by oral anticoagulants. At 3 month-follow-up, all patients became normotensive and partial or total renal artery recanalization were found (Figure 2). Conclusions. In our experience, SRAD seems to be not very rare in young and healthy patients with minimal comorbidities. Abdomen CTA is one of the “gold standard” non invasive diagnostic method. In patient treated with conservative medical therapy renal outcome is favourable. More studies are necessary to find underlying causes.

Spontaneous renal artery dissection (SRAD) is a rare entity and the management of this disease has not been established. A 54-year-old man presented with severe flank pain, and contrast-enhanced computed tomography images suggested SRAD in his left renal artery. After two weeks of conservative treatment, stents were placed in the renal artery. The pre- and post-procedural renal function was independently assessed by renography. After stenting, his left renal function recovered from the renal failure pattern. Renal artery stenting in an acute phase of SRAD may salvage the renal function, even if it appears to be non-functioning.

We aimed to compare the characteristics of the patients with renal infarction related to nontrauma renal artery dissection (RAD) with versus without an underlying vascular disease and report long-term renal and vascular outcomes, as well as new-onset renal and extra-RADs. Data from 72 consecutive patients with RAD referred to our Hypertension Unit between 2000 and 2015 were analyzed. Radiological data, including a systematic brain-to-pelvis computed tomography angiography, were independently reviewed. Three main causes of RAD were identified at the initial work-up: fibromuscular dysplasia (n=16); dissecting or aneurysmal multisite arterial disease (n=21) not linked to any known vascular disease; and isolated RAD (n=24) without any other arterial lesion. At diagnosis, patients (median age 46 [interquartile range, 40–53] years, 70.5% males, 26.2% preexisting hypertension, 65.6% smokers) had a median blood pressure of 138 (125–152)/87 (78–97) mm Hg. Estimated glomerular filtration rate was 81 (66–95) mL/min per 1.73 m 2 and 18% had renal impairment. Patients were treated with antiplatelet drugs (65.6%), anticoagulant (3.3%). A total of 11.5% underwent angioplasty. No clinical or biological difference was observed between the 3 groups. After 51 (19–92) months follow-up, blood pressure was reduced by 13 (0–29)/9 (3–18) mm Hg; 11.5% of patients had estimated glomerular filtration rate 2 . RAD evolved toward healing (67.2%), aneurysmal dilation (24.6%), or stenosis (8.2%). New-onset RAD was as frequent in dissecting or aneurysmal multisite arterial disease (23.8%) than in fibromuscular dysplasia (25%) group, whereas de novo extrarenal dissection was 6-fold more frequent in dissecting or aneurysmal multisite arterial disease (38.1%) than in fibromuscular dysplasia (6.3%) group. No new event occurred in patients with an initial diagnosis of isolated RAD. Initial diagnostic accuracy using thorough systematic exhaustive explorations of arterial sites helps to stratify the risk of new-onset dissection and adapt monitoring accordingly.

The diagnosis of renal infarction is often convoluted due to its non-specific presentation. It can mimic disease processes as disparate as pyelonephritis, diverticulitis, or nephrolithiasis. This case is further complicated by the presence of a pelvic kidney with triplicate arterial input. It is difficult to estimate the incidence of pelvic kidneys as the numerous sources vary wildly in their estimations; however, the paucity information, in and of itself, speaks to the rarity of the condition. In this case, a 58-year-old male presents to the emergency department after experiencing sharp, sudden, and severe groin pain while swinging a golf club. The patient was noted to have an abnormally high systolic blood pressure in the 170s and hematuria, but all other initial labs and assessments were unremarkable. An initial computed tomography scan with intravenous contrast of the abdomen and pelvis showed partial necrosis of a pelvic kidney. Follow-up computed tomography angiography revealed that a dissection in one of the arteries supplying the kidney created an infarction and resultant necrosis. Vessel size, location and time between injury and diagnosis made endovascular intervention impractical. The patient was started on aspirin and Plavix, observed for 3 days and sent home.

Both spontaneous superior mesenteric artery dissection (SMAD) and spontaneous renal artery dissection (SRAD) are very rare conditions. Their etiologies and natural histories are not precisely defined, but they are thought to be associated with underlying conditions. In this report, we describe an extremely rare case of SRAD in a man who had a history of spontaneous SMAD. We successfully treated SRAD with endovascular intervention. Isolated spontaneous SMAD and SRAD are both rare conditions. Their optimal treatment has not been established due to their rare entities, but endovascular treatment is a good option because it can prevent both advancement of infarction and renovascular hypertension, and it has become safer as device technology has improved. Patients with isolated visceral artery dissection should be carefully followed up.

The commonest site of primary dissection involving the visceral vessels is renal arteries; however, spontaneous bilateral renal artery dissection is an extremely rare entity. Spontaneous renal artery dissection (SRAD) is rarely a cause of renovascular hypertension. Segmental arterial mediolysis is a rare arteriopathy of unknown etiology which is a nonatherosclerotic and noninflammatory condition. We report a case of a 51-year-old male patient with spontaneous dissection of bilateral renal arteries with clinical, laboratory, and angiographic findings consistent with segmental artery mediolysis. Early diagnosis and treatment of this condition will decrease morbidity and mortality. Keywords: Segmental arterial mediolysis, Dissection, Renal hypertension

Spontaneous renal artery dissection (SRAD) is a rare disease with approximately 200 cases reported in the literature. The severity of renal compromise, the anatomic location of the dissection, and the presence of uncontrollable hypertension are used to guide the initial management of SRAD. However, there are no reported guidelines for managing the progression of SRAD after acute failure of medical management. In this case, a 40-year-old man with a recently diagnosed SRAD was managed appropriately with therapeutic anticoagulation, yet presented with progression of his dissection and a new acute renal infarct. A covered endovascular stent was used to successfully control dissection progression and prevent further renal compromise.

Spontaneous renal artery dissection is a rare cause of renal infarction and can be a diagnostic challenge at times, necessitating high index of suspicion. Other common underlying causes, especially thromboembolic phenomena, need to be considered and investigated first before making this uncommon diagnosis with vascular imaging studies. Very few cases did report strenuous exercise as a predisposing factor for the development of spontaneous renal artery dissection, but we believe that sexual intercourse has not been reported before as an underlying precipitating etiology. We report a case of a young male who presented with renal infarction that started during sexual intercourse and was found to have an angiographically proven renal artery dissection.

Constituting less than 25% of all renal artery dissections (RAD), isolated spontaneous renal artery dissection (SRAD) is a rare diagnosis that can cause subsequent renal infarction with impairment. The majority of SRAD cases are idiopathic. Management ranges from conservative, medical to endovascular, and surgical repair. We report a case of a young female on multiple medications who presented with SRAD. She presented with acute abdominal pain and was found to have isolated spontaneous renal artery dissection. The etiology of this patient’s isolated SRAD could possibly be pinned down to her multiple stimulant medications used after the major known causes were ruled out.

Spontaneous renal artery dissection is a rare disease and an uncommon cause of renal infarction. The patient was a man who presented to the emergency room with sudden-onset right flank pain. Computed tomography revealed right renal infarction; thus, anticoagulation was initiated. Renal angiography revealed luminal narrowing of the segmental artery to the superior pole of right kidney without a dissection flap or false lumen. We stopped anticoagulation due to a lack of evidence of thrombi or luminal narrowing of the dissected vessels. When patients present with acute flank pain, it is important to suspect renal infarction and to perform a correct diagnostic workup, even when the patient shows normal urinalysis results and a normal LDH value.

Fibromuscular dysplasia (FMD) is a vascular disease characterized by abnormal arterial wall architecture, usually visualized angiographically as the classic “string of beads” sign. We present the diagnostic dilemma of a 51-year-old woman admitted for a spontaneous renal infarct, with initial examination and investigations equivocal. She was consequently assessed for thromboembolic and vasculitic disease, before proceeding to digital subtraction angiography (DSA). This invasive method elucidated an area of focal FMD, previously not seen on computed tomography angiography (CTA). This is unusual due to CTA's high sensitivity and specificity but could be attributed to the less common subtype of FMD which requires combined imaging modalities to arrive at a diagnosis. Hence, there may be a role for the dual use of CTA and DSA in young patients presenting with a spontaneous renal infarct in the absence of other diagnoses.

Spontaneous renal artery dissection (SRAD) is a rare entity with less than 200 cases reported in literature. It usually affects middle-aged men and the clinical presentation is non-specific. Many times it is associated with conditions such as hypertension, fibromuscular dysplasia or vasculitides. We report the case of a patient who initially had renal infarct due to SRAD and then progressed to have bowel ischaemia. The renal infarct preceded bowel ischaemia in this patient and to the best of our knowledge this is the first such association reported in literature. Our report emphasises the point that whenever this condition is diagnosed in a patient one should be vigilant for other vascular disorders.

We present a case of spontaneous renal artery dissection (SRAD) in a 28-year-old female with history of neurofibromatosis type I (NF-1) treated successfully with endovascular stenting. The clinical presentation, diagnostic testing, and treatment options are discussed. An endovascular approach with stenting was successfully performed after failure of medical treatment with subcutaneous low molecular weight heparin. Patient’s blood pressure and symptoms improved significantly. This may be the first reported case of SRAD in a patient with NF-1 successfully treated with endovascular stenting.

We report an interesting case of a 65-year-old gentleman who presented with hypertensive emergency and was found to have an isolated spontaneous dissection of the right renal artery. The dissection was stented via endovascular approach and resulted in marked improvement in blood pressure. Spontaneous renal artery dissection is a difficult condition to diagnose and treat, unless suspected early enough during the course of treatment. Endovascular intervention is the treatment of choice, as failure of conservative treatment may have long lasting clinical implications relating to decreased renal perfusion. Surgical intervention can be associated with high rate of complications.

Background Isolated non-traumatic renal artery dissection (RAD) is a rare disorder with uncertain natural history. The management may be surgical reconstruction, endovascular repair, or conservative medical treatment, yet no official consensus had been established. Purpose To report the management of four cases of isolated non-traumatic RAD, emphasizing the beneficial role of conservative medical treatment. Material and Methods From the year 2000 till 2011, four male patients with mean age of 42.5 years (range 34–48 years) presented with isolated non-traumatic RAD and were initially treated with medical therapy. Transcatheter in situ thrombolysis was performed in a case with thrombotic occlusion. Results Isolated non-traumatic RAD in four patients involving at least seven branches progressed to thrombotic occlusion in two branches, luminal narrowing in five, dual lumens in two, and aneurysmal dilatation in three. Medical treatment was efficacious in three patients, who showed persistent preserved renal function, controlled blood pressure, and favorable arterial remodeling. After failure of medical therapy, the fourth patient was referred to surgery. Thrombolysis was successful to dissolute an occluding thrombotic dissection. Conclusion Conservative therapy is safe and effective when the renal artery is patent and blood pressure is controlled: we propose it as the first line of treatment, reserving interventional management for refractory cases.

We present a case of bilateral renal artery dissection, with the related computed tomographic images, caused by blunt torso trauma. Discussion includes the etiologies of this type of injury, the diagnostic modalities, and treatment options.

Dissection of a renal artery is rare and is usually associated with underlying arterial disease. Bilateral renal artery dissection following extreme exertion is exceptionally uncommon, and thus presents a diagnostic challenge. We report a case of a middle-aged, otherwise healthy man who presented to the hospital with left flank pain after a long bicycling trip. Initial laboratory tests and urinalysis were normal. Careful review of a contrast-enhanced computed tomography angiogram (CTA) with 3D reconstruction revealed bilateral segmental renal artery dissection and thrombosis with corresponding renal infarcts. He was treated medically and rapidly recovered.

Spontaneous renal artery dissection is a rare but important cause of flank pain. We report a case of isolated spontaneous renal artery dissection in 56-year-old man complicated by renal infarction presented with flank pain. Doppler study pointed towards vascular pathology. Computed tomography (CT) angiography was used to make final diagnosis which demonstrated intimal flap in main renal artery with renal infarction.

Spontaneous renal artery dissection (SRAD) is rare. Clinical manifestations vary from minimal symptoms to life-threatening hypertension. We analysed three cases from our institution and conducted a literature review in order to design diagnostic and treatment algorithms for SRAD.

Introduction Aortic dissections (AD) are a result of the development of a focal intimal tear, most likely caused by medial degeneration. Medial changes occur as a consequence of hemodynamics and other predisposing factors. This condition most often affects males between 40 and 70 years of age, with the history or presence of hypertension being the most consistent clinical finding. The creation of the intimal tear allows pulsatile blood to enter and propagate through the aortic media, thus forming a false channel and predisposing the patient to possible end-organ complications. Duplex ultrasound demonstrates dissection as an undulating membrane, containing asymmetrical blood flow. Aortic dissections are classified by location and extent of the intimal tear. Stanford type A (DeBakey type I) involves the ascending aorta. These dissections are life-threatening, and patients usually require emergent surgical reconstruction. Case Report A 33-year-old male with a past medical history significant for hypertension since 15 years of age was transferred from an outside hospital and presented with a greater than 5 cm ascending aortic aneurysm and a Stanford type A aortic dissection. A transesophageal echocardiogram (TEE) was performed and confirmed a type I dissection that showed extension to just below the level of the diaphragm. He was taken for emergent aortic repair. On postoperative day 1, the patient developed acute renal insufficiency. Duplex ultrasound was performed to assess renal artery flow, revealing propagation of dissection into bilateral proximal renal arteries and significant stenosis at the origin of the right renal artery. The patient underwent right renal artery percutaneous transluminal angioplasty and stent placement to restore blood flow to the right kidney. Conclusions This case demonstrates and identifies the etiology, pathology, and classifications of aortic dissection as it relates to this case. Duplex ultrasound was a safe, reliable, and sensitive tool for the evaluation of end-organ complications associated with dissection.

Objectifs L'hematome spontane dissequant des arteres renales (HSDAR) est une affection non exceptionnelle d'etio-pathogenie inconnue. Pour certains auteurs, c'est une forme clinique de dysplasie fibro-musculaire (DFM). A partir d'un registre de patients ayant ete victimes d'un HSDAR nous avons systematiquement recherche les anomalies vasculaires en faveur du diagnostic de DFM. Methodes Au cours des cinq dernieres annees (2010–2015), nous avons repertorie les cas d'HSDAR referes dans un centre universitaire regional d'hypertension arterielle. Les patients ont beneficie d'un bilan complementaire standardise comprenant une imagerie des arteres renales et des troncs supra-aortiques (angiographie numerisee, angio-TDM ou angiographie par resonance magnetique). Nous avons systematiquement realise un monitoring de la pression arterielle et de la fonction renale. Un bilan de reevaluation clinique et morphologique a ete propose a 6 mois. Resultats Six patients ont ete inclus dans ce registre. Il s'agissait de 6 hommes avec une mediane des âges de 43 ans (min : 38 ans – max : 49 ans). Trois patients etaient fumeurs actifs et trois sevres. Dans tous les cas, la presentation clinique evoquait une colique nephretique. Un patient etait prealablement hypertendu et 4 ont developpe une HTA de novo. La PA clinique moyenne a l'admission etait de 159/99 ± 23/14 mmHg. Deux patients ont presente une insuffisance renale aigue, dont une forme chronicisee (DFG 46 ml/min/1,72 m2). L'imagerie initiale revelait dans tous les cas un infarctus renal et permettait d'evoquer un hematome dissequant de l'artere renale homolaterale. L'angiographie numerisee mettait en evidence un aspect typique de DFM bilaterale chez un patient et des dilatations anevrysmales homolaterales chez trois patients. L'imagerie des troncs supra-aortiques revelait la presence d'un kingking bilateral des arteres carotides internes chez deux patients et un anevrysme de l'artere cerebrale anterieure chez un patient. Le traitement associait un anti-thrombotique (une anti-agregation plaquettaire chez 3 patients et une anticoagulation curative chez 2 patients), une therapie anti-hypertensive (1,6 molecules/patient vs 0,16 molecules/patient avant l'HSDAR) et un traitement interventionnel chez 2 patients (angioplastie seule dans un cas, et embolisation d'un anevrysme retro-pyelique en amont de la zone dissequee dans un autre cas). Conclusion L'HSDAR est une urgence vasculaire non exceptionnelle, souvent meconnue. Malgre une presentation clinique differente du tableau classique de DFM, certains patients associent a l'HSDAR des anomalies morphologiques des arteres renales et des troncs supra-aortiques compatibles avec le diagnostic de DFM.

Purpose: To describe the importance of accurate diagnosis and successful emergent endovascular repair of intimal injury to the renal artery from sudden deceleration. Case Report: A 22-year-old man was evaluated after jumping head first out of a fourth floor window. Gross hematuria was detected at the initial assessment. Contrast-enhanced computed tomography (CT) revealed diminished uptake in the right kidney. Arteriographic examination of the renal artery demonstrated 2 areas of intimal disruption, which a team of physicians decided to treat with angioplasty and stent placement owing to the associated intracranial injuries. Two balloon-expandable stents were successfully deployed to exclude the intimal defects. Once the associated injuries were also addressed, the patient made an uneventful recovery. Conclusions: Management of blunt traumatic injuries to the renal vasculature involves timely assessment to maximize preservation of renal function. In the setting of multiple concomitant injuries, recent experience supports the consideration of endoluminal intervention for traumatic renal artery dissections.

Bilateral spontaneous renal artery dissection is extremely rare with computed tomography angiography being an efficient noninvasive alternative to catheter angiography for its diagnosis. We report the case of a 65-year-old woman with bilateral spontaneous renal artery dissection resulting in bilateral renal infarctions and hydroureteronephrosis.

Patient initials or identifier number 00002721 ### Relevant clinical history and physical exam Patient is 50 year-old man with no past medical history. He smoked 15cigarettes a day. He was awoken up by left flank pain. The pain lasted for 2days before intervention. His blood pressure is 137/

Blunt renal artery injury is a relatively rare finding. The literature demonstrates an incidence as low as 0.08% of all blunt abdominal traumas, occurring in 1-4% of patients with renal injury. However, the rate of early diagnosis of such injuries is increasing due to increased awareness and the liberal use of contrast-enhanced computed tomography. In this report, we describe an approach to re-vascularization by endovascular stenting that resulted in successful salvage of renal function after blunt trauma.

WOS: 000299378800032, PubMed: 22041371, Extracorporeal shock-wave lithotripsy (ESWL) is an effective and relatively non-invasive treatment modality for ureteral or renal calculi. Although it has been accepted as a safe procedure, minor and major complications have been reported after ESWL. Spontaneous renal artery dissection (SRAD) is a rare and usually misdiagnosed condition because of non-specific presentation of the patients. Depending on the severity of the extent of the dissection non-operative or surgical treatment modalities could be performed. We represent a patient with complaints of bilateral flank pain, hematuria and hypertensive urgency who was diagnosed as having bilateral SRAD possibly secondary to ESWL and chronic hypertension.

Renal artery angioplasty and stenting has become the initial treatment of choice for many patients with symptomatic atherosclerotic renal artery stenosis. Iatrogenic renal artery dissection is one of the most feared complications and usually occurs either at the time the lesion is crossed with a guidewire or during dilation.

Case Report A previously healthy 37-year-old man presented to an outside hospital with an acute onset of sharp left lower quadrant pain that radiated into his groin while mowing the lawn. The pain was continuous, lasting until the patient presented to the emergency room of his local community hospital. He denied any trauma or sudden changes in position. The patient identified no aggravating or alleviating factors for the pain. The pain was associated with nausea and one episode of bilious, non-bloody emesis. He also noted urinary hesitancy but denied hematuria.

Spontaneous, isolated focal renal artery dissection is an extremely rare cause of renovascular hypertension. Imaging technology for the renal arteries has evolved recently with the development of multidetector computed tomography angiography (CTA), and intravascular ultrasound. We describe a 52-year-old man with spontaneous renal artery dissection complicated by renovascular hypertension, successfully diagnosed initially with CTA, then evaluated by intravascular ultrasound, and finally, treated successfully with stenting.

A normotensive 42-year-old man presented to the emergency department with sudden onset of severe left flank pain and vomiting. x Rays, blood tests and urinalysis were normal. …

We report a case of spontaneous superior pole renal artery dissection in a healthy forty-one year old man. Spontaneous renal artery dissection is a rare event occurring in patients with hypertension or renovascular disease such as fibromuscular dysplasia. This case demonstrates the importance of maintaining renovascular accidents as part of the differential diagnosis of abdominal pain.

We report a rare case of isolated spontaneous renal artery dissection treated by stent placement. A 59-year-old man presented with a sudden onset of left flank pain and severe hypertension together with elevated creatinine levels. A computed tomography scan revealed a focal dissection at the left renal artery (LRA) with an infarcted left kidney. Despite medical treatment with 4 drugs, the patient's blood pressure remained uncontrolled. Angiography confirmed the diagnosis. A 6- × 60-mm Xpert stent (Abbott Vascular, Temecula, CA) was deployed at the LRA, achieving an enlarged true lumen with a patent stent. After the procedure, acute renal impairment was observed but pain subsided and blood pressure normalized under the treatment prescribed. At 12 months of follow-up, the patient was normotensive and asymptomatic with mild chronic renal failure and a patent LRA stent on doppler ultrasonography. The endovascular treatment of isolated spontaneous renal artery dissection appears to be feasible and effective and could be the first-line treatment when revascularization is needed.

An 80-year-old man underwent elective endovascular repair for an infrarenal abdominal aortic aneurysm 65 mm in size. Baseline angiography showed the normal renal arteries ([Fig. 1][1]A). Angiography after the endovascular graft implantation (Zenith, Cook, Inc., Bloomington, Indiana) revealed a