Percutaneous transluminal angioplasty procedure for central venous stenosis inpatient undergoing hemodialysis in Pelni Hospital: case series

Introduction: Many causes leads to kidney impairment. This does not rule out the increasing number of patients undergoing hemodialysis. The common vascular access used during hemodialysis is an arteriovenous fistula (AVF). The arteriovenous fistula was preferred because it lasts longer and has a lower risk of infection for vascular access, meanwhile central venous stenosis or occlusion in the vein that carries the blood from the extremities to the heart often occur. If vascular access is still used during hemodialysis in which central venous stenosis is formed, it needs to make a new vascular access option. Percutaneous transluminal angiography (PTA) main objectives are to dilate the venous lesion that has occlusion more than 50% and extending the lifespan of arteriovenous fistula. In this case, we report six patients hemodialysis with central venous stenosis treated with percutaneous transluminal angiography. This procedure has benefits that are arteriovenous fistula can be used again to reach hemodialysis adequacy optimally and reduce pain and swelling in the arms. Case description: There six cases who were 45,48,57.58,63 and 66 years old who underwent percutaneous transluminal angioplasty procedures for central venous stenosis. Several past illnesses of the patients underlying the kidney impairment such chronic hypertension, chronic coronary heart complications, and/or diabetes. Several patients felt AVF swollen and/or painful. Minimal residual stenosis after balloon angioplasty was performed. Conclusion: According to our cases, patients that underwent the hemodialysis felt swollen or/and pain due to stenosis ballooning angioplasty help minimize the residual stenosis.

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

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.