A case of simultaneous adrenalectomy and dissection repair with direct sheath placement into the aorta and systematic review of cases with hyperaldosteronism and vascular dissection: a case report
Abstract Background The incidence of acute aortic dissections is 3–6 patients per 100,000 in a year, with a high mortality rate of 40% at the initial diagnosis and increasing to 90% in an hour. There are several known risk factors for acute aortic dissection; however, the most common risk factor is...
Saved in:
| Main Authors: | , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2025-05-01
|
| Series: | Journal of Medical Case Reports |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s13256-025-05276-1 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1850128174653898752 |
|---|---|
| author | Meghdad Ghasemi Gorji Alireza Keshtkar Ali Rafiei Parsa Yazdanpanahi Alireza Karimi |
| author_facet | Meghdad Ghasemi Gorji Alireza Keshtkar Ali Rafiei Parsa Yazdanpanahi Alireza Karimi |
| author_sort | Meghdad Ghasemi Gorji |
| collection | DOAJ |
| description | Abstract Background The incidence of acute aortic dissections is 3–6 patients per 100,000 in a year, with a high mortality rate of 40% at the initial diagnosis and increasing to 90% in an hour. There are several known risk factors for acute aortic dissection; however, the most common risk factor is systemic hypertension. Different conditions have been reported to be associated with resistant hypertension, including hyperaldosteronism. Case presentation A 57-year-old Persian man came to our clinic with occasional claudication after 30 m distance walking, left leg pain, and symptoms of chronic limb ischemia, including a cold left leg with a shiny appearance. He had a past medical history of recently diagnosed resistant hypertension and a past surgical history of a femoropopliteal bypass and a balloon angioplasty. His computed tomography angiography of the abdominopelvic cavity and lower limbs revealed a dissection of the infrarenal aorta at the bifurcation of common iliac arteries, occlusion of the left external iliac artery, and dissection of the left common iliac artery. In addition, a mass measuring 6 cm × 5 cm × 2 cm was identified in the patient’s left adrenal gland. The ostium of the false lumen was in the distal part of dissection so we decided to use an antegrade approach to repair the dissection. He underwent simultaneous surgeries for aneurysmal repair and adrenalectomy. Conclusion A vast systematic search of literature in Scopus, Web of Science, PubMed, and Google Scholar was carried out to identify cases of hyperaldosteronism relating to vascular dissection that were either treated with surgery or medication. Our results support the theory suggesting that hyperaldosteronism can be considered a risk factor for vascular dissection despite its effects on hypertension. |
| format | Article |
| id | doaj-art-73c8f5f405834b13b267f986fbc081c2 |
| institution | OA Journals |
| issn | 1752-1947 |
| language | English |
| publishDate | 2025-05-01 |
| publisher | BMC |
| record_format | Article |
| series | Journal of Medical Case Reports |
| spelling | doaj-art-73c8f5f405834b13b267f986fbc081c22025-08-20T02:33:25ZengBMCJournal of Medical Case Reports1752-19472025-05-0119111110.1186/s13256-025-05276-1A case of simultaneous adrenalectomy and dissection repair with direct sheath placement into the aorta and systematic review of cases with hyperaldosteronism and vascular dissection: a case reportMeghdad Ghasemi Gorji0Alireza Keshtkar1Ali Rafiei2Parsa Yazdanpanahi3Alireza Karimi4Department of Surgery, School of Medicine, Namazi Teaching Hospital, Shiraz University of Medical SciencesResearch Center for Noncommunicable Diseases, Jahrom University of Medical SciencesDepartment of Vascular Surgery, Shiraz University of Medical ScienceDepartment of Vascular Surgery, Shiraz University of Medical ScienceDepartment of Vascular Surgery, Shiraz University of Medical ScienceAbstract Background The incidence of acute aortic dissections is 3–6 patients per 100,000 in a year, with a high mortality rate of 40% at the initial diagnosis and increasing to 90% in an hour. There are several known risk factors for acute aortic dissection; however, the most common risk factor is systemic hypertension. Different conditions have been reported to be associated with resistant hypertension, including hyperaldosteronism. Case presentation A 57-year-old Persian man came to our clinic with occasional claudication after 30 m distance walking, left leg pain, and symptoms of chronic limb ischemia, including a cold left leg with a shiny appearance. He had a past medical history of recently diagnosed resistant hypertension and a past surgical history of a femoropopliteal bypass and a balloon angioplasty. His computed tomography angiography of the abdominopelvic cavity and lower limbs revealed a dissection of the infrarenal aorta at the bifurcation of common iliac arteries, occlusion of the left external iliac artery, and dissection of the left common iliac artery. In addition, a mass measuring 6 cm × 5 cm × 2 cm was identified in the patient’s left adrenal gland. The ostium of the false lumen was in the distal part of dissection so we decided to use an antegrade approach to repair the dissection. He underwent simultaneous surgeries for aneurysmal repair and adrenalectomy. Conclusion A vast systematic search of literature in Scopus, Web of Science, PubMed, and Google Scholar was carried out to identify cases of hyperaldosteronism relating to vascular dissection that were either treated with surgery or medication. Our results support the theory suggesting that hyperaldosteronism can be considered a risk factor for vascular dissection despite its effects on hypertension.https://doi.org/10.1186/s13256-025-05276-1Adrenal glandsHyperaldosteronismDissectionBlood vesselsAortic dissection |
| spellingShingle | Meghdad Ghasemi Gorji Alireza Keshtkar Ali Rafiei Parsa Yazdanpanahi Alireza Karimi A case of simultaneous adrenalectomy and dissection repair with direct sheath placement into the aorta and systematic review of cases with hyperaldosteronism and vascular dissection: a case report Journal of Medical Case Reports Adrenal glands Hyperaldosteronism Dissection Blood vessels Aortic dissection |
| title | A case of simultaneous adrenalectomy and dissection repair with direct sheath placement into the aorta and systematic review of cases with hyperaldosteronism and vascular dissection: a case report |
| title_full | A case of simultaneous adrenalectomy and dissection repair with direct sheath placement into the aorta and systematic review of cases with hyperaldosteronism and vascular dissection: a case report |
| title_fullStr | A case of simultaneous adrenalectomy and dissection repair with direct sheath placement into the aorta and systematic review of cases with hyperaldosteronism and vascular dissection: a case report |
| title_full_unstemmed | A case of simultaneous adrenalectomy and dissection repair with direct sheath placement into the aorta and systematic review of cases with hyperaldosteronism and vascular dissection: a case report |
| title_short | A case of simultaneous adrenalectomy and dissection repair with direct sheath placement into the aorta and systematic review of cases with hyperaldosteronism and vascular dissection: a case report |
| title_sort | case of simultaneous adrenalectomy and dissection repair with direct sheath placement into the aorta and systematic review of cases with hyperaldosteronism and vascular dissection a case report |
| topic | Adrenal glands Hyperaldosteronism Dissection Blood vessels Aortic dissection |
| url | https://doi.org/10.1186/s13256-025-05276-1 |
| work_keys_str_mv | AT meghdadghasemigorji acaseofsimultaneousadrenalectomyanddissectionrepairwithdirectsheathplacementintotheaortaandsystematicreviewofcaseswithhyperaldosteronismandvasculardissectionacasereport AT alirezakeshtkar acaseofsimultaneousadrenalectomyanddissectionrepairwithdirectsheathplacementintotheaortaandsystematicreviewofcaseswithhyperaldosteronismandvasculardissectionacasereport AT alirafiei acaseofsimultaneousadrenalectomyanddissectionrepairwithdirectsheathplacementintotheaortaandsystematicreviewofcaseswithhyperaldosteronismandvasculardissectionacasereport AT parsayazdanpanahi acaseofsimultaneousadrenalectomyanddissectionrepairwithdirectsheathplacementintotheaortaandsystematicreviewofcaseswithhyperaldosteronismandvasculardissectionacasereport AT alirezakarimi acaseofsimultaneousadrenalectomyanddissectionrepairwithdirectsheathplacementintotheaortaandsystematicreviewofcaseswithhyperaldosteronismandvasculardissectionacasereport AT meghdadghasemigorji caseofsimultaneousadrenalectomyanddissectionrepairwithdirectsheathplacementintotheaortaandsystematicreviewofcaseswithhyperaldosteronismandvasculardissectionacasereport AT alirezakeshtkar caseofsimultaneousadrenalectomyanddissectionrepairwithdirectsheathplacementintotheaortaandsystematicreviewofcaseswithhyperaldosteronismandvasculardissectionacasereport AT alirafiei caseofsimultaneousadrenalectomyanddissectionrepairwithdirectsheathplacementintotheaortaandsystematicreviewofcaseswithhyperaldosteronismandvasculardissectionacasereport AT parsayazdanpanahi caseofsimultaneousadrenalectomyanddissectionrepairwithdirectsheathplacementintotheaortaandsystematicreviewofcaseswithhyperaldosteronismandvasculardissectionacasereport AT alirezakarimi caseofsimultaneousadrenalectomyanddissectionrepairwithdirectsheathplacementintotheaortaandsystematicreviewofcaseswithhyperaldosteronismandvasculardissectionacasereport |