We report two cases of an unusual cause of the acute onset of hypertension, a spontaneous dissecting aneurysm localized to the renal artery. Also reviewed are 16 reported cases from the literature. The mean age of the 18 patients was 52 years. The majority of these patients were males (78 per cent). Hypertension was a presenting sign in 14 (78 per cent), but was not usually a preexisting feature. Loin pain, often severe, occurred in eleven patients (61 per cent), whereas gross hematuria was recorded only in two (11 per cent). The right renal artery was involved in ten cases (55 per cent), the left in three (17 per cent), and both in five cases (28 per cent). Atherosclerosis of the renal arteries and the aorta was absent in 69 per cent, and mild in 23 per cent. There has been no report of renal artery rupture; however, vascular occlusion occurs frequently. Medical and surgical approaches to the management of this phenomenon have been reported and are reviewed.
ASJC Scopus subject areas
- Cardiology and Cardiovascular Medicine