Renal Artery Stenting for Traumatic Dissection.
Glenn Yang Han Ng, Joel Jingkai Liu, Haiyuan Shi, Kentson Jing Xin Lee
Abstract
Open AccessRenal injuries are frequently seen in the context of trauma, with currently well-established guidelines for classification and management, such as those prescribed by the American Association for the Surgery of Trauma. However, traumatic dissection of the renal arteries specifically is uncommon; clarity regarding optimal management is currently lacking, despite the possible long-term sequelae, including loss of nephron function and renovascular hypertension. While medical management alone had sometimes been suggested, endovascular stenting is potentially a viable minimally invasive intervention that may further reduce the risk of long-term complications. In this report, we present a case of traumatic renal artery dissection first seen on computed tomography in a patient who presented following a high-speed road traffic accident. Percutaneous endovascular stenting of a dissected renal artery was performed, with subsequent restoration of renal perfusion on follow-up imaging, as well as maintenance of normal serum creatinine and blood pressure at longer-term follow-up. We also review the existing literature, which, despite the scarcity, affirms our experience of favourable outcomes post-intervention.