Chen Yang, Dong Hui, Jiang Xiongjing, Che Wuqiang
Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 167, Beilishi Road, Xicheng District, Beijing, China.
Eur Heart J Case Rep. 2019 Jun 1;3(2). doi: 10.1093/ehjcr/ytz014.
Renal artery intramural haematoma (IMH) is a rare cause of renal artery obstruction after stenting. Diagnosis and treatment are difficult as there are only a few cases reported.
We present the case of sudden-onset abdominal pain and non-functional kidney 3 days after renal artery stent implantation. Subacute luminal narrowing of the renal artery was initially diagnosed using computed tomography angiography and renal artery angiography, and a final diagnosis of subacute renal artery IMH was made using intravascular ultrasound (IVUS). Subsequently, the patient was treated with percutaneous transluminal angioplasty from far to near and another stent implantation. At the third month follow-up, blood pressure and renal function were normal.
This case suggests that IVUS could be useful for qualifying and treating the subacute renal artery IMH.
肾动脉壁内血肿(IMH)是肾动脉支架置入术后肾动脉梗阻的罕见原因。由于仅有少数病例报道,其诊断和治疗较为困难。
我们报告1例肾动脉支架植入术后3天突发腹痛且患侧肾功能丧失的病例。最初通过计算机断层血管造影和肾动脉血管造影诊断为肾动脉亚急性管腔狭窄,最终通过血管内超声(IVUS)确诊为亚急性肾动脉IMH。随后,对患者进行了从远心端到近心端的经皮腔内血管成形术及再次支架植入术。在第三个月的随访中,血压和肾功能均正常。
该病例提示IVUS在亚急性肾动脉IMH的定性和治疗中可能有用。