Laparoscopy-Assisted Hybrid Technique for Renal Revascularization Using an Endovascular Graft: Report of Three Cases

Vascular ◽  
2007 ◽  
Vol 15 (3) ◽  
pp. 154-157 ◽  
Author(s):  
Chris N. Bakoyiannis ◽  
Catherine Cagiannos ◽  
Sergej Wasilljew ◽  
Laslo Pinter ◽  
Ralf Kolvenbach

Atherosclerotic renal artery stenosis (RAS) is relatively common and often associated with hypertension and progressive renal insufficiency. Technical improvements of interventional endovascular tools have led to a more widespread use of endoluminal renal artery revascularization. Sometimes an endovascular procedure for (RAS) may fail. We report 3 cases successfully treated with laparoscopic assisted aortorenal bypass using an endovascular graft.

2016 ◽  
Vol 31 (9) ◽  
pp. 1437-1443 ◽  
Author(s):  
Wei Wang ◽  
Ahmed Saad ◽  
Sandra M. Herrmann ◽  
Alfonso Eirin Massat ◽  
Michael A. McKusick ◽  
...  

2003 ◽  
Vol 131 (5-6) ◽  
pp. 208-210 ◽  
Author(s):  
Dimitra Kalimanovska-Ostric ◽  
Branislava Ivanovic ◽  
Vladimir Ostric ◽  
Vesna Knezevic ◽  
Vesna Stojanov ◽  
...  

One of the clinical manifestations of renovascular hypertenzion (RVH) may be a recurrent pulmonary oedema both in the absence or in the presence of systolic left ventricular dysfunction. This type of pulmonary oedema characterized as "flash" pulmonary oedema is ascribed to elevated angiotensin II concentrations with consequent hypertension as well as to volume overload resulting from decreased pressure natriuresis when there are significant stenoses of both or one renal arteries. The investigation included 30 patients with RVH treated by percutaneous transluminal angioplasty of the stenosed renal artery (PTRA) and/or stent implantation (PTR-ST) and 30 patients with surgical resection of the abdominal aortic aneurysm (AAA). The first group was divided in two subgroups according to the etiology of renal artery stenosis (RAS). In the subgroup with fibromuscular dysplasia (FMD) the mean age was 37.5 years, in the subgroup with atherosclerotic renal artery stenosis (ARAS) 54.8 years and in the group with operated AAA 68.6 years. There were more females than males only in the FMD subgroup (10:3). Two patients of the first group experienced pulmonary oedema, both in the subgroup with atherosclerotic renal artery stenosis associated with atherosclerosis of other arteries. Normalization of the blood pressure following PTRA in both and an uncomplicated course after a surgical myocardial revascularization in one of them illustrates the importance of renal revascularization. Pulmonary oedema occurred preoperatively in four out of 30 patients with abdominal aortic aneurysm in whom significant renal artery stenoses coexisted. Two patients died despite surgery, one patient is clinically stable and the medicament treatment of heart failure is inevitable in the fourth with a left ventricular aneurysm following myocardial infarction. The occurrence or reoccurrence of pulmonary oedema in the absence of other explanation should suggest the possibilty of billateral or unilateral renal artery stenosis requiring renal revascularization for blood pressure regulation as well as for elimination of other manifestations/complications.


2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
A Kablak-Ziembicka ◽  
A Roslawiecka ◽  
R Badacz ◽  
A Sokolowski ◽  
P Musialek ◽  
...  

Abstract Background It is little known about predictors of systolic (SBP) and diastolic (DBP) blood pressure or renal function (eGFR) improvement in patients with atherosclerotic renal artery stenosis (ARAS) undergoing stent-assisted angioplasty (PTA). Therefore, we aimed to build a prediction scores that would indicate characteristics of patient subsets with ARAS most likely to have clinical improvement following PTA. Methods 201 patients who underwent PTA for ARAS (2003–2018) were categorized as eGFR or SBP/DBP responders based on eGFR increase of ≥11 ml/min/1.73m2, decrease of SBP ≥20mmHg and DBP ≥5mmHg at 12-months following PTA. The remaining patients were classified as non-responders. The performance of logistic regression models were evaluated by basic decision characteristics. Continuous data have been transformed into binary coding with help of operating characteristic (ROC) curve. Predictive models have been constructed for each followed by construction of predictive models in each of 3 categories. Results Logistic regression analysis showed that: baseline SBP>145 mmHg, DBP >82 mmHg, previous myocardial infarction and Renal-Aotric-Ratio >5.1 were independent influencing factors of SBP response, with relative risk percentage shares of 69.8%; 12.1%; 10.9%; and 7.2%, respectively (sensitivity: 82%, specificity: 86.3%, positive (PPV):82% and negative (NPV) predictive values: 86.3%). The DBP decrease prediction model included baseline SBP >145 mmHg and DBP >82 mmHg, the ARAS progression, index kidney length >106 mm, and bilateral PTA with respective shares of 35.0%; 21.8%; 18.2%; 13.3% and 11.8%. (sensitivity: 76%, specificity: 77.8%, PPV: 80.7% and NPV: 72.6%). The eGFR increase was associated with baseline serum creatinine >122 μmol/L but eGFR greater than 30 ml/min/1.73m2, index kidney length >98 mm, end-diastolic velocity in index renal artery, renal resistive index <0.74, and requirement for >3 BP medications, with respective shares of 24.4%; 24.4%; 21.2%; 15% and 15% (sensitivity: 33.3%, specificity: 93.5%, PPV: 65.6% and NPV: 78.9%). Conclusions Current study identified clinical characteristics of patients who most likely to respond to PTA for ARAS. The sutability of the score should be verified in a prospective cohort of patients referred to PTA of ARAS Funding Acknowledgement Type of funding source: None


1995 ◽  
Vol 75 (15) ◽  
pp. 1051-1055 ◽  
Author(s):  
Gerald Dorros ◽  
Michael Jaff ◽  
Aditiya Jain ◽  
Christine Dufek ◽  
Lynne Mathiak

Hypertension ◽  
2010 ◽  
Vol 55 (4) ◽  
pp. 961-966 ◽  
Author(s):  
Monika L. Gloviczki ◽  
James F. Glockner ◽  
Lilach O. Lerman ◽  
Michael A. McKusick ◽  
Sanjay Misra ◽  
...  

Sign in / Sign up

Export Citation Format

Share Document