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KMID : 0904020000160010119
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Journal of Korean Society for Vascular Surgery
2000 Volume.16 No. 1 p.119 ~ p.123
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Treatment of Fibromuscular Dysplasia of the Abdominal Aorta Causing Renovascular Hypertension and Aneurysm
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Abstract
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Fibromuscular dysplasia (FMD) involving the abdominal aorta and renal artery is a rare disease that cause aneurysmal dilatation, occlusion of the affected blood vessel, or sometimes renovascuiar hypertension. Recently, we experienced a case of FMD involving abdominal aorta and renal artery. The patient was 39 year old male and had been suffered from claudication of the right leg and uncontrollable hypertension. In abdominal CT and arteriography, infrarenal abdominal aorta and both common iliac arteries showed aneurysmal dilatation and occlusion of right common iliac artery. The same time, there was a complete occlusion of left renal artery and stenosis of the origin of right renal artery. Renal scan displayed non-functioning left kidney and normal functioning right kidney. Plasma renin activity (PRA) was highly elevated and ABI was markedly decreased in the right leg. Aorto-biiliac bypass using the knitted Dacron was performed and right kidney was autotransplanted into the right pelvis anastomosing renal artery into the intemal iliac artery following endarterectomy of renal artery during bench procedure. And finally, left nephrectomy was done. After operation, blood pressure was normalized and PRA was 0.09 ng/ml/hr. ABI of the right leg was improved. Postoperative course was uneventful and discharged on post-operative day 27.
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