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Renal Artery Dissections
Bruce L. Gewertz, MD;
James C. Stanley, MD;
William J. Fry, MD
Arch Surg. 1977;112(4):409-414.
Abstract
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• Renal artery dissections encountered in 15 patients, aged 3 to 75 years, were categorized as to pathogenesis (blunt abdominal trauma, catheter injury, and spontaneous). Blunt traumatic dissections (seven patients) were characterized by hypertension, gross hematuria, and pain. Catheter-induced dissections (four patients) were asymptomatic, although two exhibited accelerated hypertension. Spontaneous dissections (four patients) were all associated with preexistent arterial disease. Symptoms in these patients were uncommon, despite accelerated hypertension in three cases. Intravenous pyelography lacked specific diagnostic value for renal artery dissections. Early arteriographic examination proved essential in diagnosis and surgical treatment. Criteria for operative intervention included existence of technically correctable dissections causing (1) hemodynamically significant occlusions of the main or major segmental renal arteries, (2) documented renovascular hypertension, or (3) significant deterioration of renal function.
(Arch Surg 112:409-414, 1977)
Author Affiliations
From the Department of Surgery, University of Michigan Medical Center, Ann Arbor.
Footnotes
Accepted for publication Dec 8, 1976.
Read before the 84th annual meeting of the Western Surgical Association, Coronado, Calif, Nov 15, 1976.
Reprint requests to University Hospital, 1405 E Ann St, Ann Arbor MI 48109 (Dr Gewertz).
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ABSTRACT
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