scholarly journals Renal artery stenosis of atherosclerotic etiology – the single kidney surgical recurrence 12 years after nephrectomy

2016 ◽  
Vol 63 (3) ◽  
pp. 251-254
Author(s):  
Maria Daniela Tănăsescu ◽  
◽  
Marcel Pălămar ◽  
Mihai Ovidiu Comşa ◽  
Alexandru Mincă ◽  
...  
Keyword(s):  
Renal Artery ◽  
Renal Artery Stenosis ◽  
Left Kidney ◽  
Secondary Hypertension ◽  
Artery Stenosis ◽  
The Other ◽  
Left Renal Artery ◽  
Arterial Blood ◽  
The Moment ◽  
The Right

Objectives. Renal artery stenosis, as main cause of renovascular secondary hypertension, is mainly caused by atherosclerosis of large vessels and is clinically characterized by resistant or malignant hypertension, impacting the kidney function to various degrees. The present article brings into attention the case of a patient which developed renal artery stenosis on the left kidney, the same condition occurring 12 years later on the right kidney. Material and method. Our patient was initially diagnosed at the age of 48 with complete occlusion of the left renal artery, for which left nephrectomy was performed, while the right artery was normal. Twelve years later she presents with renal artery stenosis on the right kidney, which is treat by stent-angioplasty. Results. After surgery, the patient’s evolution was positive, with amelioration of the laboratory values, in parallel to the arterial blood pressure. Discussions. The probability that, in the moment of diagnosis of renal artery stenosis with progressive evolution to occlusion caused by atherosclerosis, the other artery would be normal, both seen by ultrasonography and angiography, while years later to develop stenosis, is minimal. Up to present, the literature holds little evidence of such similar cases. Conclusions. In the particular case of patients that were diagnosed with severe renal artery stenosis of atherosclerotic origin and had only one of the arteries affected, it is necessary to keep a permanent monitoring, justified by the risk of development of the same pathology to the other artery

scholarly journals CLINICAL CASE OF ARTERIAL HYPERTENSION IN A NEWBORN

2021 ◽  
Vol 11 (4(42)) ◽  
pp. 96-101
Author(s):  
K. Bertsun ◽  
O. Rubina ◽  
O. Gorbatyuk ◽  
O. Moravska ◽  
T. Mashnitska ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Conservative Treatment ◽  
Arterial Hypertension ◽  
Renal Artery ◽  
Renal Artery Stenosis ◽  
Arterial Blood Pressure ◽  
Left Kidney ◽  
Artery Stenosis ◽  
Left Renal Artery ◽  
Arterial Blood

Aim. To use personal clinical experience in monitoring and treating a newborn with persistent arterial hypertension (AH) due to left renal artery stenosis to demonstrate the current state of this problem in the context of limited experience of work with such rare pathologies in children.Materials and methods. The research was based on the examination and treatment of a newborn with persistent AH due to left renal artery stenosis. The complex of diagnostic procedures included: clinical and laboratory examinations, X-ray examination methods (with the use of contrast agents), magnetic resonance imaging, ultrasound examination and Dopplerography, and histological examination of surgical material.Results. Conservative treatment of the patient's AH with the use of antihypertensive agents did not achieve desired results.Taking into account possible etiologic and pathogenetic factors of AH in newborns, Doppler examination was performed to exclude congenital heart defects (coarctation of the aorta). Pathology was excluded.Cortisol and 17-OH progesterone levels were determined to exclude suprarenal pathology and showed the following: cortisol level was 173.9% higher than the maximum permissible level; 17-OH progesterone level was 9.9% higher than the norm.Considering the presence of neurological symptoms, an MRI of the brain with angiography was performed. No pathology was detected.Due to the presence of persistent arterial hypertension, which did not respond to medication, a CT with contrast was ordered, during which were revealed CT-signs of critically small diameter of the left renal artery (probable dissection) with pronounced cystic and ischemic changes of the lateral half of the left kidney without excretory function at 15 min. The main treatment measures included the following: adequate preoperative preparation, anesthetic support and the selection of an adequate and effective operative method to eliminate the pathology. The only available method of surgical intervention was nephrectomy - removal of the left kidney.Analyzing the results of the investigation, it can be stated that nephrectomy is the pathogenetic method of treatment of this pathology. Steady stabilization of arterial blood pressure was achieved within 1 hour after the operation.Conclusions. 1. When persistent AH is detected in a newborn, the presence of organic pathology should be excluded. 2. If the patient has organic pathology that causes a persistent increase in arterial blood pressure, the root cause of the pathology should be eliminated if possible. 3. Conservative treatment of persistent AH in children caused by renovascular or renal factors does not provide significant results and is not appropriate. 4. Nephrectomy is the pathogenetic method of treating AHT in a newborn with renal artery stenosis.

Use of shockwave intravascular lithotripsy for the treatment of calcified renal artery stenosis in a symptomatic subject

2020 ◽  
Vol 16 (5) ◽  
pp. 419-423
Author(s):  
S Schnupp ◽  
I Ajmi ◽  
M Sinani ◽  
J Brachmann ◽  
C Mahnkopf
Keyword(s):  
Renal Artery ◽  
Renal Artery Stenosis ◽  
Artery Stenosis ◽  
Left Renal Artery ◽  
Shockwave Lithotripsy ◽  
Refractory Hypertension ◽  
Atherosclerotic Renal Artery Stenosis ◽  
Wall Apposition ◽  
The Right ◽  
Symptomatic Subject

Aim: The use of shockwave lithotripsy for the treatment of heavily calcified atherosclerotic plaques before stenting showed great results in terms of feasibility and safety with favorable initial success. Evidence suggests that it is a useful tool to treat calcified lesions in peripheral and coronary arteries. Here, we describe the case of a patient with calcified renal artery stenosis successfully treated with the shockwave lithotripsy system. Case Report: We present a 76-year-old man with a known significant atherosclerotic renal artery stenosis and refractory hypertension. The patient received an angioplasty of the right renal artery in the first session and he was admitted for a second session to intervene in the left renal artery. The lesion was successfully treated with the lithotripsy system. Final angiography demonstrated an excellent position of the stent and good wall apposition. Conclusion: Our clinical case demonstrates that lithotripsy is safe and effective also for the treatment of the renal artery.

scholarly journals Case report of secondary hypertension due to renal artery stenosis in young patient

2014 ◽  
Vol 23 (2) ◽  
pp. 117-21
Author(s):  
Wendy M. Saragih ◽  
Siska Sulistiowati ◽  
Nur Haryono ◽  
Bambang B. Siswanto ◽  
Nani Hersunarti ◽  
...  
Keyword(s):  
Case Report ◽  
Renal Artery ◽  
Young Patient ◽  
Renal Artery Stenosis ◽  
Secondary Hypertension ◽  
Artery Stenosis ◽  
Left Renal Artery ◽  
Bilateral Renal Artery Stenosis ◽  
Bilateral Renal Artery ◽  
Percutaneous Transluminal Angiography

Secondary hypertension is rare to occur, but should become suspicion in young age. Secondary hypertension must be appropriately diagnosed and treated. Renal artery stenosis is one of many causes of secondary hypertension. The aim of this case report is to describe diagnosis, pathophysiology and management of secondary hypertension due to renal artery stenosis in young patient. A 17 year old man with symptom of shortness of breath was diagnosed with hypertension stage 3 on his medical examination at Pasar Rebo Hospital, Jakarta. Abdominal CT scan examination revealed bilateral renal artery stenosis. Percutaneous transluminal angiography (PTA) of left renal artery was performed at National Cardiovascular Centre Harapan Kita. Stent was placed succesfully and the blood pressure was normalized.

scholarly journals Recurrent Pleural Effusion as a Result of Bilateral Renal Artery Stenosis. Does Renal Revascularization Help?

2018 ◽  
Vol 11 ◽  
pp. 117954761876137
Author(s):  
Ashraf Abugroun ◽  
Marion Gonzalez ◽  
Daniel Vilchez
Keyword(s):  
Renal Function ◽  
Pleural Effusion ◽  
Renal Artery ◽  
Renal Artery Stenosis ◽  
Secondary Hypertension ◽  
Artery Stenosis ◽  
Systemic Hypertension ◽  
Left Renal Artery ◽  
Bilateral Renal Artery Stenosis ◽  
Cardiopulmonary Complications

Renal artery stenosis (RAS) is the leading cause of secondary hypertension. Renal artery stenosis can result in various cardiopulmonary complications mostly through activation of neurohormonal pathways that result in fluid overload and systemic hypertension. We herein describe a 72-year-old man with recurrent rapidly accumulating transudative pleural effusion in a patient with severe bilateral RAS. Patient pleural effusion resolved following stent placement with revascularization of the left renal artery despite absence of improvement of renal function. Patient renal function continued to decline and ultimately treated with fixed hemodialysis.

Traumatic Left Renal Artery Stenosis Managed with Splenorenal Bypass

1990 ◽  
Vol 30 (12) ◽  
pp. 1594-1596 ◽  
Author(s):  
GARY W. BARONE ◽  
MARK B. KAHN ◽  
JAMES M. COOK ◽  
BERNARD W. THOMPSON ◽  
ROBERT W. BARNES ◽  
...  
Keyword(s):  
Renal Artery ◽  
Renal Artery Stenosis ◽  
Artery Stenosis ◽  
Left Renal Artery

Improved Technique for Aorto-Renal Reconstruction: A Haemodynamic Approach

1973 ◽  
Vol 45 (s1) ◽  
pp. 315s-316s
Author(s):  
U. Ruberti ◽  
A. Vegeto ◽  
E. Malan
Keyword(s):  
Renal Artery ◽  
Renal Artery Stenosis ◽  
Vena Cava ◽  
Artery Stenosis ◽  
Improved Method ◽  
End To End ◽  
Renal Reconstruction ◽  
The Right ◽  
Improved Technique

1. An improved method of aorto-renal reconstruction in renal artery stenosis is described. 2. The Dacron prosthesis is inserted high in the aorta, thus avoiding a recurrent course and limiting turbulence. 3. The prosthesis is inserted end-to-end in the reconstructed renal artery. 4. On the right side the restructured renal artery is placed anterior to the vena cava. 5. These modifications result in a wide anastomosis with maximum haemodynamic effectiveness.

scholarly journals Refractory hypertension secondary to renal artery stenosis with a honeycomb-like structure

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Cheng Chen ◽  
Ying Zhang ◽  
Da Yin ◽  
Yan Liu ◽  
Yunpeng Cheng ◽  
...  
Keyword(s):  
Renal Artery ◽  
Renal Artery Stenosis ◽  
Fibrous Tissue ◽  
Honeycomb Structure ◽  
Artery Stenosis ◽  
Proximal Segment ◽  
Left Renal Artery ◽  
Renal Infarction ◽  
Refractory Hypertension ◽  
Spider Web

Abstract Background A honeycomb-like structure (HLS) is a rare abnormality characterized by a braid-like appearance. Angiograph and intravascular examination, including coherence tomography and intravascular ultrasound (IVUS), can further confirm the multiple intraluminal channels or honeycomb structure, which can also be described as looking like ‘swiss cheese’, a ‘spider web’ or a ‘lotus root’. Previous studies have mostly reported this abnormality in coronary arteries, with a few cases in renal arteries. More information about the characteristics and development of HLS is needed. Case presentation A 69-year-old Han man with resistant hypertension received abdominal enhanced computerised tomography and was revealed to have left renal artery stenosis with the possibility of left renal infarction. Renal artery angiography confirmed a 95% stenosis located in the proximal segment of the left renal artery, and the middle segment was blurred with multi-channel-like blood flow. Further IVUS was performed and identified multiple channels surrounded by fibrous tissue. It was a rare case of HLS in the renal artery secondary to the thrombus, with organisation and recanalisation. Balloon dilatation and stent implantation at the proximal segment of the left renal artery were performed successfully. Blood pressure was well controlled after the procedure. Conclusions The IVUS findings are helpful for forming interventional therapeutic strategies for HLS lesions in the renal artery.

scholarly journals Thoracolumbar Junction Syndrome Accompanying Renal Artery Stenosis: A Case Repor

2020 ◽  
Vol 44 (1) ◽  
pp. 85-89
Author(s):  
Kyudong Noh ◽  
Jong Burm Jung ◽  
Jeong Won Seong ◽  
Doh-Eui Kim ◽  
Dongrak Kwon ◽  
...  
Keyword(s):  
Renal Artery ◽  
Renal Artery Stenosis ◽  
Correct Diagnosis ◽  
Flank Pain ◽  
Artery Stenosis ◽  
Common Reason ◽  
Thoracolumbar Junction ◽  
Left Renal Artery ◽  
Paravertebral Muscles ◽  
Minor Improvement

Flank pain is a common reason for visits to the emergency room. The most common reason warranting hospital visits are urology-related problems. However, there are many other causes, such as musculoskeletal lesions, that difficult to achieve a correct diagnosis. Here, we describe a rare case of flank pain caused by thoracolumbar junction syndrome, accompanying renal artery stenosis. A 54-year-old male with hypertension presented with severe left flank pain for 1 week. Initially, he was diagnosed with left renal artery stenosis by computed tomography and decreased renal function on renal scan (Tc-99m DTPA). Although a stent was inserted into the left renal artery, flank pain persisted with only minor improvement. Through detailed physical examination, he was finally diagnosed with thoracolumbar junction syndrome. After three injections in the left deep paravertebral muscles at the T10–T12 levels, flank pain completely ceased. Clinicians must consider thoracolumbar junction syndrome, when treating patients with flank pain.

scholarly journals Case report: secondary hypertension in a 6-year old child with bilateral renal artery stenosis

2020 ◽  
Vol 1 (2) ◽  
pp. 45-50
Author(s):  
Tatyana A. Ryazanova ◽  
Yuliya A. Trunova ◽  
Anastasia S. Arkhipova
Keyword(s):  
Case Report ◽  
Renal Artery ◽  
Renal Artery Stenosis ◽  
Renovascular Hypertension ◽  
Fibromuscular Dysplasia ◽  
Clinical Symptoms ◽  
Secondary Hypertension ◽  
Renal Arteries ◽  
Artery Stenosis ◽  
Bilateral Renal Artery Stenosis

Background. Renovascular hypertension (RVH) is an elevated blood pressure caused by partial or complete occlusion of one or both renal arteries or their branches. According to different studies, renal artery stenosis accounts for 5–10% of all cases of hypertension in children. The most common causes of renal artery stenosis are deemed to be atherosclerosis and fibromuscular dysplasia.Case description. The article describes clinical case of a newly diagnosed renovascular hypertension amid background of fibromuscular dysplasia of renal arteries in a 6-year old child, particulars of the clinical course, laboratory and instrumental methods of investigation and treatment including aortography and balloon angioplasty of renal arteries.Conclusion. This case report illustrates that in the absence of complaints and pronounced clinical symptoms the diagnosis of renovascular hypertension in a 6-year old child could not be established for a long time. Timely detection of elevated BP in children, including the young ones, not only during visiting specialist physicians but also during prophylactic examination by pediatrician, is required for early diagnosis of the disease and development of the examination and treatment strategy.

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