Key result
Island patch technique successfully preserves bilateral accessory renal arteries during complex aortoiliac reconstruction.
Why the study?
Secondary hypertension caused by accessory renal arteries is a controversial and rare condition with few reported cases, requiring further study to clarify its role in hypertension.
Case Report (n=1)
May support technical feasibility of island patch in select cases; leaves open need for larger studies before broader adoption.
BACKGROUND: Secondary hypertension is a relatively rare condition most commonly caused by renovascular disease due to atherosclerotic vascular disease or fibromuscular dysplasia. Although accessory renal arteries are frequent, to date, only six cases of secondary hypertension determined by their existence have been reported. CASE SUMMARY: We describe a case of a 39-year-old female who came to the emergency department with an urgent hypertensive crisis and hypertensive encephalopathy. Despite normal renal arteries, the computed tomography angiography revealed an inferior polar artery with 50% stenosis of its diameter. Conservative treatment with amlodipine, indapamide and perindopril was adopted, leading to blood pressure control within one month. CONCLUSION: To the best of our knowledge, there are controversies regarding accessory renal arteries as a potential etiology for secondary hypertension, but the seven similar cases already described, along with the current case, could reinforce the necessity of more studies concerning this subject.
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Calinoiu et al. (2023) conducted a case report in Symptomatic aortoiliac atherosclerotic disease with accessory renal arteries (n=1). Open surgical revascularization with preservation of accessory renal arteries via island patch reimplantation was evaluated. Open surgical revascularization with an island patch technique successfully preserved large bilateral accessory renal arteries in a young patient with severe aortoiliac atherosclerosis.
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