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Renal artery stenosis

Fen Chen, Shulin Li, Dong Sun
Blood oxygen level-dependent magnetic resonance imaging (BOLD MRI) has recently been utilized as a noninvasive tool for evaluating renal oxygenation. Several methods have been proposed for analyzing BOLD images. Regional ROI selection is the earliest and most widely used method for BOLD analysis. In the last 20 years, many investigators have used this method to evaluate cortical and medullary oxygenation in patients with ischemic nephropathy, hypertensive nephropathy, diabetic nephropathy, chronic kidney disease (CKD), acute kidney injury and renal allograft rejection...
March 8, 2018: Kidney & Blood Pressure Research
Saroj Neupane, Sushruth Edla, Eesha Maidona, Matthew C Sweet, Susan Szpunar, Thomas Davis, Thomas A LaLonde, Rajendra H Mehta, Howard S Rosman, Hiroshi Yamasaki
OBJECTIVES: To evaluate the association of diabetes mellitus (DM) with clinical and angiographic characteristics and outcomes of patients with popliteal and infrapopliteal peripheral arterial disease (PAD) undergoing peripheral vascular intervention (PVI). BACKGROUND: Clinical features and outcomes in patients with DM and popliteal or infrapopliteal PAD undergoing PVI are not well described. METHODS: Using the data from the laser in popliteal and infrapopliteal stenosis study, we retrospectively examined the association of diabetes with clinical and angiographic characteristics and risk adjusted short- and intermediate term outcomes (all cause death, major adverse events (MAE) [composite of death, ipsilateral major amputation, or repeat revascularization]) in patients with popliteal and infrapopliteal PAD undergoing PVI for critical limb ischemia treated either with laser-assisted balloon angioplasty or balloon angioplasty alone...
March 14, 2018: Catheterization and Cardiovascular Interventions
Tetsutaro Matayoshi, Kei Kamide, Ryoichi Tanaka, Tetsuya Fukuda, Takeshi Horio, Yoshio Iwashima, Fumiki Yoshihara, Satoko Nakamura, Hajime Nakahama, Yusuke Ohya, Yuhei Kawano
Background: The results of recent trials have brought some confusion to the treatment strategy for renal artery stenosis (RAS). To evaluate the applicability of percutaneous transluminal renal angioplasty (PTRA) for RAS, we extracted the factors that may affect the effectiveness of PTRA from cases experienced at a hypertension center. Methods and Results: We retrospectively assessed the blood pressure (BP) lowering effects and renoprotective effects in 50 consecutive patients that had hemodynamically significant RAS and had undergone PTRA and stenting during 2001-2005...
2018: International Journal of Hypertension
Nupoor Narula, Daniella Kadian-Dodov, Jeffrey W Olin
Fibromuscular dyplasia (FMD) is an under-recognized non-atherosclerotic, non-inflammatory arteriopathy that occurs most commonly in middle-aged women, but may affect individuals of all age groups. FMD may result in stenosis, aneurysm, dissection, occlusion, or arterial tortuosity. Recently published data demonstrated a genetic association of FMD with a variant in the phosphatase and actin regulator 1 gene (PHACTR1), substantiating that the pathogenesis of this condition has genetic contribution. The renal and extracranial carotid and vertebral arteries are most often involved, although any arterial bed may be affected...
March 10, 2018: Progress in Cardiovascular Diseases
Shunta Hori, Mitsuru Tomizawa, Fumisato Maesaka, Takuya Owari, Yosuke Morizawa, Yasushi Nakai, Makito Miyake, Tatsuo Yoneda, Nobumichi Tanaka, Katsunori Yoshida, Kiyohide Fujimoto
BACKGROUND: Page kidney phenomenon is caused by strong renal parenchymal compression and leads to renal hypoperfusion and microvascular ischemia, resulting in renal dysfunction and hypertension. Although the development of Page kidney phenomenon in allograft is rare, most of its cases are induced by allograft biopsy or trauma. We observed a case of Page kidney phenomenon that was induced by unusual causes immediately after kidney transplantation. CASE PRESENTATION: A 66-year-old man, whose wife donated a kidney, underwent ABO-compatible living kidney transplantation...
March 13, 2018: BMC Nephrology
Ashraf Abugroun, Marion Gonzalez, Daniel Vilchez
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...
2018: Clinical Medicine Insights. Case Reports
Yoko Kaneko, Takamoto Yanagawa, Yoshinori Taru, Sonoko Hayashi, Hong Zhang, Tomoki Tsukahara, Tsuneaki Matsunaga, Takashi Ishizu
INTRODUCTION: We describe a hemodialysis patient who developed subclavian steal syndrome via an arteriovenous fistula after percutaneous transluminal angioplasty. CASE DESCRIPTION: A 55-year-old female with end-stage renal failure due to polycystic kidney disease had been treated with hemodialysis for 10 years. Because of an autologous arteriovenous fistula stenosis, percutaneous transluminal angioplasty was performed. After successful treatment with percutaneous transluminal angioplasty, the patient developed dizziness...
March 1, 2018: Journal of Vascular Access
Piotr Dobrowolski, Magdalena Januszewicz, Anna Klisiewicz, Aleksander Prejbisz, Ewa Warchoł-Celińska, Ilona Michałowska, Elżbieta Florczak, Katarzyna Kożuch, Katarzyna Hanus, Anna Aniszczuk-Hybiak, Helena Witowicz, Adam Witkowski, Jacek Kądziela, Marek Kabat, Krzysztof Madej, Sławomir Nazarewski, Andrzej Tykarski, Łukasz Stryczyński, Małgorzata Szczerbo-Trojanowska, Łukasz Światłowski, Przemysław Kosiński, Krystyna Widecka, Andrzej Januszewicz, Piotr Hoffman
OBJECTIVE: To provide a comprehensive assessment of left ventricle (LV) structure, and function and to detect alterations in cardiac properties in relationship to presence, subtypes and extent of fibromuscular dysplasia (FMD). METHODS: We studied 144 patients with FMD. The control group consisted of 50 matched individuals. Office and ambulatory blood pressure levels were evaluated. Echocardiography was employed to assess: left ventricular mass index (LVMI), systolic function including speckle tracking echocardiography and diastolic function assessed by mitral flow and tissue Doppler imaging...
March 9, 2018: Journal of Hypertension
Xiaohang Li, Jialin Zhang, Yiman Meng, Lei Yang, Fengshan Wang, Baifeng Li, Xitong Zhang
BACKGROUND: Renal transplant is the preferred treatment option for these patients with end-stage renal disease. Transplant renal artery stenosis (TRAS) is one of the most common and serious vascular complications after renal transplantation, and most of the TRAS occurred in the anastomosis. The complication must be diagnosed and treated timely, otherwise the function of transplanted kidney may be losed. CASE PRESENTATION: A 46-year-old male with end-stage renal disease of unknown cause received a cadaveric renal transplant one year ago...
March 9, 2018: BMC Nephrology
Philip W Stather, James Ferguson, Ayoola Awopetu, Jonathan R Boyle
OBJECTIVE/BACKGROUND: The effect of suprarenal (SR) as opposed to infrarenal (IR) fixation on renal outcomes post-endovascular aneurysm repair (EVAR) remains controversial. This meta-analysis aims to update current understanding of this issue. METHODS: A prior meta-analysis was updated through a Preferred Reporting Items for Systematic reviews and Meta-Analyses search for additional studies published in the last 3 years reporting on renal dysfunction or related outcomes post-EVAR...
March 2, 2018: European Journal of Vascular and Endovascular Surgery
Yan-Na Liu, Li-Xin Yu, Wen-Feng Deng, Kai-Qun Li, Ru-Min Liu, Gui-Rong Ye, Fang-Xiang Fu, Jiang-Tao Li, Yun Miao
OBJECTIVE: To investigate the factors associated with the occurrence of transplant renal artery stenosis (TRAS). METHODS: A retrospective analysis was conducted in 26 recipients who developed TRAS and 40 concurrent renal recipients without TRAS. We also conducted a nested case-control study in 14 patients with TRAS (TRAS-SD group) and another 14 non-TRAS recipients who received the allograft from the same donor (non-TRAS-SD group). RESULTS: Compared with those in the concurrent recipients without TRAS, acute rejection (AR) occurred at a significantly higher incidence (P=0...
February 20, 2018: Nan Fang Yi Ke da Xue Xue Bao, Journal of Southern Medical University
Huanrui Hu, Xiyang Chen, Zhoupeng Wu, Jichun Zhao, Bin Huang, Yukui Ma, Ding Yuan, Yi Yang, Fei Xiong
We report an aneurysm degeneration of a vein graft in a previous aortorenal bypass performed five years earlier for severe right renal artery stenosis due to Takayasu arteritis. The patient was a 31-year-old woman who suffered from refractory hypertension. The autogenous bypass adopting great saphenous vein was performed from her infrarenal abdominal aorta to her right renal artery. Five years after the operation, the patient complained vague discomfort in her abdomen. Three-dimensional computed tomography angiography reconstruction demonstrated the existence of an aneurysm with a maximum diameter of 1...
March 1, 2018: Annals of Vascular Surgery
Meng Luen Lee, Ming Yuh Chang, Tung Ming Chang, Rei Cheng Yang, Ming Che Chang, Albert D Yang
Concurrent involvement of bilateral renal and cerebral arteries, usually incurred as stenosis, is rare in childhood-onset Takayasu arteritis (c-TA). We report the case of a 14-year-old girl, with c-TA, presenting with transient ischemic attack after endovascular revascularization for renal artery stenosis and cerebrovascular stroke after surgical revascularization for cerebral artery stenosis associated with childhood-onset moyamoya syndrome. We deem that decrease of blood pressure by endovascular revascularization and improvement of cerebral perfusion by surgical revascularization may have jeopardized the cerebral deep watershed zone to cerebral ischemia followed by cerebral hyperperfusion syndrome and caused transient ischemic attack and cerebrovascular stroke in our patient...
March 5, 2018: Journal of Korean Medical Science
Ayman Samman Tahhan, Pratik Sandesara, Salim S Hayek, Muhammad Hammadah, Ayman Alkhoder, Heval M Kelli, Matthew Topel, Wesley T O'Neal, Nima Ghasemzadeh, Yi-An Ko, Mohamad Mazen Gafeer, Naser Abdelhadi, Fahad Choudhary, Keyur Patel, Agim Beshiri, Gillian Murtagh, Jonathan Kim, Peter Wilson, Leslee Shaw, Viola Vaccarino, Stephen E Epstein, Laurence Sperling, Arshed A Quyyumi
BACKGROUND: The associations between high-sensitivity troponin I (hsTnI) levels and coronary artery disease (CAD) severity and progression remain unclear. We investigated whether there is an association between hsTnI and angiographic severity and progression of CAD and whether the predictive value of hsTnI level for incident cardiovascular outcomes is independent of CAD severity. METHODS AND RESULTS: In 3087 patients (aged 63±12 years, 64% men) undergoing cardiac catheterization without evidence of acute myocardial infarction, the severity of CAD was calculated by the number of major coronary arteries with ≥50% stenosis and the Gensini score...
February 21, 2018: Journal of the American Heart Association
Clemens Grupp, Michael J Koziolek, Manuel Wallbach, Kerstin Hoxhold, Gerhard A Müller, Carsten Bramlage
Detection of renal artery stenosis (RAS) using Doppler is difficult to evaluate, particularly under conditions such as bilateral RAS or difficultly accessible renal arteries (RA). The objective of the present study was to assess the utility of splenic arterial compared to renal flow as an additional parameter in the Doppler evaluation of RAS. The difference between the resistive indices (RI) determined in renal and splenic parenchymal arteries (ΔRI K-S ) was evaluated in 181 hypertensive subjects without any evidence of RAS...
February 16, 2018: Journal of Clinical Hypertension
Sandhya Manohar, Abdurrahman Hamadah, Sandra M Herrmann, Stephen C Textor
Current trends in managing atherosclerotic renal artery stenosis favor medical therapy, on account of negative results from prospective trials of revascularization, such as CORAL and ASTRAL. One result of this trend has been encountering occasional patients with progressive disease, sometimes leading to total arterial occlusion. We illustrate a case of accelerated hypertension with complete renal artery occlusion in which the patient recovered function after surgical bypass and we review the clinical approach used and the advanced imaging modalities available to us...
February 8, 2018: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
Akash Chitrakar, Kajan Raj Shrestha, Uttam Krishna Shrestha
A 39-year lady referred to Vascular Surgery OPD from Cardiology with uncontrolled hypertension, non- functional left kidney and absent bilateral femoral pulses. Investigations revealed middle aortic syndrome with non-functional left kidney with bilateral renal artery stenosis. She successfully underwent bypass of stenotic segment with polyester graft from descending thoracic aorta to left common iliac artery with reverse saphenous vein graft interposed between polyester and right renal artery.
September 2017: Journal of Surgical Case Reports
Huiqi Jiang, Henrik Hultkvist, Jonas Holm, Farkas Vanky, Yanqi Yang, Rolf Svedjeholm
OBJECTIVE: The primary aim was to investigate the role of underlying heart disease on preoperative NT-proBNP levels in patients admitted for adult cardiac surgery, after adjusting for the known confounders age, gender, obesity and renal function. The second aim was to investigate the predictive value of preoperative NT-proBNP with regard to severe postoperative heart failure (SPHF) and postoperative mortality. METHODS: A retrospective cohort study based on preoperative NT-proBNP measurements in an unselected cohort including all patients undergoing first time surgery for coronary artery disease (CAD; n = 2226), aortic stenosis (AS; n = 406) or mitral regurgitation (MR; n = 346) from April 2010 to August 2016 in the southeast region of Sweden (n = 2978)...
2018: PloS One
Manuel Pereira Marques Gomes Júnior, Cláudia Maria Rodrigues Alves, Adriano Henrique Pereira Barbosa, Adriano Caixeta, Marcelo Costa Batista, José Osmar Medina Pestana, Antônio Carlos Carvalho
OBJECTIVE: To describe and standardize an original protocol for fractional flow reserve (FFR) pre and postangioplasty in an initial series of patients with clinically manifested transplant renal artery stenosis (TRAS). BACKGROUND: There is no data in the literature about the use of FFR in TRAS. METHODS: Patients with TRAS detected in a noninvasive study were referred to diagnostic angiography and stenosis considered visually severe (≥ 60%) were included...
February 7, 2018: Catheterization and Cardiovascular Interventions
Erica E ElSeed Peterson, Daniel Mauriello
Post-patent ductus arteriosus ligation syndrome is common, but rarely has hypertension been described following ductal ligation with an unclear mechanism. We report a case of an infant who exhibited features of post-patent ductus arteriosus ligation syndrome and hypertension, but was found to have bilateral renal artery stenosis. Increased systemic vascular resistance can be masked by the parallel circuit physiology of a patent ductus arteriosus.
February 7, 2018: Cardiology in the Young
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