Progressive Fibromusclular Dysplasia of the Renal Artery

1985 ◽  
Vol 26 (6) ◽  
pp. 705-708 ◽  
Author(s):  
L. E. Lörelius ◽  
A. Hemmingsson ◽  
A. Hägg ◽  
C. Mörlin ◽  
H. Åberg
Keyword(s):  
Fibromuscular Dysplasia ◽  
Transluminal Angioplasty ◽  
Luminal Diameter ◽  
Score System ◽  
Existing Problems ◽  
Frequent Use ◽  
The Right ◽  
Progressive Disorder ◽  
Percutaneous Transluminal

Eight patients with unilateral and 12 patients with bilateral fibromuscular dysplasia of the renal arteries were re-examined after 3 to 11 (mean 6) years. Angiographic progression was evaluated in a score system and occurred in 19 of the 20 patients, 83 per cent had progression on the right and 54 per cent on the left side. The most frequent indications of progressive disorder were increase in the length of the lesion and the number of membraneous stenoses. Less sensitive was the determination of least luminal diameter, mainly due to difficulties in measuring this in the majority of cases. Nine of the patients had clinical progression of hypertension. These patients did not differ in angiographic score from the 11 without such progression. Because of the progressive nature of the disease and the existing problems to evaluate the hemodynamic significance of fibromuscular dysplasia, a frequent use of percutaneous transluminal angioplasty is recommended.

scholarly journals Acute pancreatitis following coronary angiography: case report and review of contrast-induced pancreatitis

2020 ◽  
Vol 7 (3) ◽  
pp. 870
Author(s):  
Jasmine J. Mui ◽  
Raphael Shamavonian ◽  
Kim Chi Phan Thien
Keyword(s):  
Acute Pancreatitis ◽  
Coronary Angiography ◽  
Capillary Flow ◽  
Epigastric Pain ◽  
Transluminal Angioplasty ◽  
Intravenous Contrast ◽  
Causative Factors ◽  
The Right ◽  
Rare Phenomena ◽  
Percutaneous Transluminal

Acute pancreatitis is a common surgical presentation with a multitude of causative factors. While the pathogenesis is not completely understood, new potential triggers have been described in recent literature. Contrast-induced pancreatitis is one of these rare phenomena. We present a case of acute pancreatitis in a patient who underwent coronary angiography and discuss the suspected pathogenesis behind contrast-induced pancreatitis. A 65-year-old man with background of cholecystectomy and UroLift procedure underwent two-stage elective coronary angiography following an episode of angina. He had been started on perindopril, rosuvastatin, aspirin and clopidogrel the week prior following first-stage percutaneous transluminal angioplasty of the right coronary artery. The patient underwent uncomplicated angiography, receiving 120 ml of Omnipaque 350. After transfer to the ward, he complained of progressive epigastric pain and nausea. On examination, the patient was afebrile, haemodynamically stable and tender in the epigastrium. His lipase was 888 U/l. Liver ultrasound showed an absent gallbladder but no other abnormalities. Total cholesterol was 2.7 mmol/l and IgG subclasses within normal range. There was no indication to perform an EUS. His symptoms resolved and his lipase normalised within three days. Although contrast-induced pancreatitis is rare, it should be considered in patients exposed to intravenous contrast who manifest symptoms. It occurs due to reduced capillary flow resulting from increased viscosity of radiographic contrast. The rate of invasive coronary investigations continues to rise with cardiovascular disease affecting one in five Australians. Therefore contrast-induced pancreatitis will likely become more common in this population hence it is important to be recognised.

scholarly journals Percutaneous transluminal angioplasty for central venous stenosis or occlusion in hemodialysis patients

2018 ◽  
Vol 20 (1_suppl) ◽  
pp. 87-92 ◽  
Author(s):  
Yuki Horita
Keyword(s):  
Percutaneous Transluminal Angioplasty ◽  
Interventional Therapy ◽  
Transluminal Angioplasty ◽  
Radial Force ◽  
Brachiocephalic Vein ◽  
Central Venous ◽  
Central Venous Stenosis ◽  
Venous Stenosis ◽  
The Right ◽  
Percutaneous Transluminal

The objectives of central venous percutaneous transluminal angioplasty are to dilate the venous lesion and to extend the life of arteriovenous fistula for hemodialysis. It is reasonable to perform percutaneous transluminal angioplasty for central venous lesions if this interventional therapy is required to maintain stable dialysis therapy. However, the presence of large fresh thrombus at central venous lesion site represents a contraindication to percutaneous transluminal angioplasty unless the thrombus can first be removed by thrombectomy. Balloon angioplasty is a basic treatment for central venous lesion, but stent implantation is sometimes required. The self-expandable or balloon-expandable stent is chosen by the lesion location and characteristics. The lesion in subclavian vein is generally treated by self-expandable stent and right brachiocephalic vein is treated by balloon-expandable stent. The organic lesion of innominate vein with plaque is treated by self-expandable stent. Note that the innominate venous stenosis is sometimes caused by compression between the right brachiocephalic artery and the sternum, and this lesion is treated by balloon-expandable stent because the radial force of balloon-expandable stent is stronger than self-expandable stent. It is important to understand the indication and stent selection for central venous percutaneous transluminal angioplasty.

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