Management of isolated non-traumatic renal artery dissection: report of four cases

BackgroundIsolated 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.PurposeTo report the management of four cases of isolated non-traumatic RAD, emphasizing the beneficial role of conservative medical treatment.Material and MethodsFrom 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.ResultsIsolated 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,...