Open AccessRenovascular hypertension: endovascular therapy in complicated aortic Stanford type B dissection
Author(s) -
Janosch Cupa,
Hans-Jörg Hippe,
Philipp Schäfer,
Norbert Frey,
C. Langer
Publication year - 2018
Publication title -
cardiovascular diagnosis and therapy
Language(s) - Uncategorized
Resource type - Journals
SCImago Journal Rank - 0.83
H-Index - 22
eISSN - 2223-3660
pISSN - 2223-3652
DOI - 10.21037/cdt.2017.11.06
Subject(s) - medicine , renovascular hypertension , aortic dissection , blood pressure , cardiology , ostium , right renal artery , renal artery , stenosis , aorta , stent , renal artery stenosis , angiography , aortic pressure , chest pain , surgery , radiology , kidney
A 63 years old male with a history of arterial hypertension presented with a current onset of chest pain and discrete headaches accompanied with dizziness. His blood pressure, 210/110 mmHg, had worsened and showed a reversed circadian rhythm with an average of 150/90 mmHg during night time. A CT angiography of the aorta demonstrated a type B dissection involving the right renal artery causing reduced perfusion of the right kidney. Subsequent invasive aortic angiography showed a continuously moving aortic dissection flap resulting in a dynamic stenosis proven by varying pressure gradients of between 5 and 35 mmHg. Stent placement of the renal artery ostium kept the vessel open and fixed the reno-aortic dissection flap in order to prevent it from progressing into the right kidney. Follow-up examinations revealed improved blood pressure control allowing for physiologic drop of blood pressure during night-time.