Harada Makoto, Miyashita Yusuke, Ichikawa Tohru, Kobayashi Mamoru
Department of Nephrology, Nagano Red Cross Hospital, Nagano, Japan.
Department of Nephrology, Shinshu University School of Medicine, Matsumoto, Japan.
Case Rep Nephrol Dial. 2018 Nov 27;8(3):253-260. doi: 10.1159/000494716. eCollection 2018 Sep-Dec.
Coral reef aorta is rare type of atherosclerotic diseases with severe calcification in the visceral part of the aorta. We present a case of coral reef aorta with severe abdominal aortic stenosis in a 67-year-old man. The patient presented with hypertension, claudication, and rapid progression of renal dysfunction over several months. Angiography revealed a severely stenotic suprarenal abdominal aorta resulting in renal ischemia and dysfunction. In addition, his right kidney was completely atrophied. After open surgical repair of the stenotic aorta including renal artery reconstruction, renal function did not improve. There was stenotic anastomosis to the renal artery. After endovascular therapy to the stenotic anastomosis, renal function dramatically improved. Stenotic coral reef aorta may be the cause of kidney dysfunction. In addition, surgical complication of stenotic anastomosis may be successfully treated by endovascular therapy.
珊瑚礁样主动脉是一种罕见的动脉粥样硬化疾病，主动脉内脏部分有严重钙化。我们报告一例67岁男性患有严重腹主动脉狭窄的珊瑚礁样主动脉病例。该患者表现为高血压、间歇性跛行，且在数月内肾功能迅速恶化。血管造影显示肾上腺上方腹主动脉严重狭窄，导致肾缺血和肾功能障碍。此外，他的右肾完全萎缩。在对狭窄的主动脉进行开放手术修复包括肾动脉重建后，肾功能并未改善。肾动脉吻合处存在狭窄。对狭窄的吻合处进行血管内治疗后，肾功能显著改善。狭窄的珊瑚礁样主动脉可能是肾功能障碍的原因。此外，血管内治疗可成功治疗狭窄吻合处的手术并发症。
