Andrew B Dicks1, Islam Y Elgendy2, Vikas Thondapu3, Brian Ghoshhajra3, Harold D Waller4, Manolo Rubio5, Robert M Schainfeld5, Ido Weinberg5. 1. Fireman Vascular Center, Massachusetts General Hospital, 55 Fruit Street, Boston, MA, 02114, USA. andrew.dicks@prismahealth.org. 2. Department of Medicine, Weill Cornell Medicine-Qatar, Doha, Qatar. 3. Department of Radiology, Massachusetts General Hospital, Boston, MA, USA. 4. Department of Vascular Surgery, Massachusetts General Hospital, Boston, MA, USA. 5. Fireman Vascular Center, Massachusetts General Hospital, 55 Fruit Street, Boston, MA, 02114, USA.
Abstract
OBJECTIVES: The natural history and optimal management of spontaneous renal artery dissections (SRADs) are poorly understood. We compared baseline characteristics, presentation, management, and outcomes between patients with symptomatic versus asymptomatic SRADs. METHODS: We performed a retrospective review of medical charts for patients diagnosed with SRAD at a single, tertiary care center. Patients were identified using billing codes. Patient demographics, medical history, clinical presentation, treatment, and follow up were recorded. We compared patients based on presence or absence of symptoms at the time of SRAD diagnosis. RESULTS: A total of 125 patients were included; 73 (58.4%) patients had symptoms at the time of SRAD diagnosis. Symptomatic patients were younger at the time of diagnosis (47.4 vs. 54.3 years, p = 0.008) and more likely male (74.0% vs. 44.2%, p = 0.005). Most patients received medical therapy (93.2% vs. 82.6%, p = 0.32). Endovascular therapy utilization was low in both groups (8.2% vs. 7.7%, p = 0.9). Outcomes between the two groups were comparable; renal function remained stable, and mortality was rare. CONCLUSION: Most patients who presented with SRAD were treated with medical therapy alone and usually experienced a benign course. Further studies are needed to understand the pathophysiology and natural history of renal artery dissections.
OBJECTIVES: The natural history and optimal management of spontaneous renal artery dissections (SRADs) are poorly understood. We compared baseline characteristics, presentation, management, and outcomes between patients with symptomatic versus asymptomatic SRADs. METHODS: We performed a retrospective review of medical charts for patients diagnosed with SRAD at a single, tertiary care center. Patients were identified using billing codes. Patient demographics, medical history, clinical presentation, treatment, and follow up were recorded. We compared patients based on presence or absence of symptoms at the time of SRAD diagnosis. RESULTS: A total of 125 patients were included; 73 (58.4%) patients had symptoms at the time of SRAD diagnosis. Symptomatic patients were younger at the time of diagnosis (47.4 vs. 54.3 years, p = 0.008) and more likely male (74.0% vs. 44.2%, p = 0.005). Most patients received medical therapy (93.2% vs. 82.6%, p = 0.32). Endovascular therapy utilization was low in both groups (8.2% vs. 7.7%, p = 0.9). Outcomes between the two groups were comparable; renal function remained stable, and mortality was rare. CONCLUSION: Most patients who presented with SRAD were treated with medical therapy alone and usually experienced a benign course. Further studies are needed to understand the pathophysiology and natural history of renal artery dissections.
Authors: Heather L Gornik; Alexandre Persu; David Adlam; Lucas S Aparicio; Michel Azizi; Marion Boulanger; Rosa Maria Bruno; Peter de Leeuw; Natalia Fendrikova-Mahlay; James Froehlich; Santhi K Ganesh; Bruce H Gray; Cathlin Jamison; Andrzej Januszewicz; Xavier Jeunemaitre; Daniella Kadian-Dodov; Esther Sh Kim; Jason C Kovacic; Pamela Mace; Alberto Morganti; Aditya Sharma; Andrew M Southerland; Emmanuel Touzé; Patricia van der Niepen; Jiguang Wang; Ido Weinberg; Scott Wilson; Jeffrey W Olin; Pierre-Francois Plouin Journal: Vasc Med Date: 2019-01-16 Impact factor: 3.239
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Authors: Daniella Kadian-Dodov; Heather L Gornik; Xiaokui Gu; James Froehlich; J Michael Bacharach; Yung-Wei Chi; Bruce H Gray; Michael R Jaff; Esther S H Kim; Pamela Mace; Aditya Sharma; Eva Kline-Rogers; Christopher White; Jeffrey W Olin Journal: J Am Coll Cardiol Date: 2016-07-12 Impact factor: 24.094