Korean Journal of Nephrology 2000;19(1):138-142.

증례 : 자상후 유발된 지연성 신동맥류 및 신동맥-하대정맥루에 의한 신성 고혈압 1예 (A case of Delayed Renavascular Hypertension in Stab Injury Induced Renal Artery-IVC Fistula and Its Renal Artery Aneurysm)

최승옥(Seung Ok Choi),한병근(Byoung Geun Han),김진수(Jin Soo Kim),이은영(Eun Young Lee),김재권(Jae Kwon Kim),김영주(Young Ju Kim),구철희(Chul Hoe Koo)

Abstract

Renovascular hypertension is the most common cause of curable hypertension. The exact prevalence of renovascular hypertension is not known, and the diagnosis is probably missed in many patients. It is important to recognize this condition in clinical practice, first, because it is a correctable form of secondary hypertension, and second, it is a reversible cause of renal failure in some patients. The Basic lesion of renovascular hypertension is stenosis of the renal artery caused usually by either one of the two most common etiologies, atherosclerosis or fibromuscular dysplasia. Other known causes of renovascular hypertension include aneurysm, embolism, arterio venous fistula, neurofibromatosis, tumor, hematoma, foreign body induced compression, and trauma. Its treatment can be divided into surgical intervention, percutaneous transluminal balloon angioplasty, and medical therapy. Recently, selective embolization has been introduced as a useful alter native therapeutic modality in the management of arterio venous fistula and aneurysm. We report a case of delayed renovascular hyper-tension in stab injury induced renal artery-IVC fistula and its renal artery aneurysm in a 20 year-old man. Embolization of the renal arterio venous fistula was achieved by inserting a detachable balloon, and embolization of the renal aneurysm and lumbar artery pseudoaneurysm was performed using micro-eo-ils. Arteriogram immediately after embolization con- firmed complete occlusion of the ancurysm and closure of the arterio venous fistula. After the procedure, improvement of blood pressure was noted in the patient who is currently being followed-up on an out-patient basis.