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Renal artery stenosis

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https://www.readbyqxmd.com/read/28521931/hemodynamic-measurements-for%C3%A2-the%C3%A2-selection-of-patients-with-renal%C3%A2-artery%C3%A2-stenosis-a-systematic-review
#1
REVIEW
Peter M van Brussel, Tim P van de Hoef, Robbert J de Winter, Liffert Vogt, Bert-Jan van den Born
Interventions targeting renal artery stenoses have been shown to lower blood pressure and preserve renal function. In recent studies, the efficacy of catheter-based percutaneous transluminal renal angioplasty with stent placement has been called into question. In the identification of functional coronary lesions, hyperemic measurements have earned a place in daily practice for clinical decision making, allowing discrimination between solitary coronary lesions and diffuse microvascular disease. Next to differences in clinical characteristics, the selection of renal arteries suitable for intervention is currently on the basis of anatomic grading of the stenosis by angiography rather than functional assessment under hyperemia...
May 22, 2017: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/28509120/complex-glomerular-pathology-of-thrombotic-microangiopathy-and-focal-segmental-glomerulosclerosis-forms-tumor-like-mass-in-a-renal-transplant-donor-with-severe-renovascular-hypertension
#2
Michio Nagata, Yutaka Yamaguchi, Daisuke Toki, Izumi Yamamoto, Hiroaki Shinmura, Hiroshi Kawaguchi
The pathogenesis of glomerular hypertension-mediated FSGS and its histological variations in humans remains unknown. A 47-year-old man developed nephrotic syndrome, renal dysfunction, and malignant hypertension 2 years after donating a kidney to his son. The donor's remnant kidney developed renal mass at an upper pole which was fed by an aberrant artery that branched from the root of the renal artery. Furthermore, the main non-aberrant renal artery demonstrated severe stenosis that caused renovascular hypertension, resulting in malignant hypertension...
May 2017: CEN Case Reports
https://www.readbyqxmd.com/read/28502640/a-cohort-study-reveals-myocarditis-to-be-a-rare-and-life-threatening-presentation-of-large-vessel-vasculitis
#3
Katie Bechman, Deepa Gopalan, Petros Nihoyannopoulos, Justin C Mason
BACKGROUND: The predominant forms of adult large vessel vasculitis (LVV) are giant cell arteritis (GCA) and Takayasu arteritis (TA). Cardiac involvement in LVV is a cause of morbidity and mortality, particularly in TA. Cardiac failure is most commonly secondary to uncontrolled arterial hypertension or myocardial ischaemia. Pulmonary hypertension and aortic valve incompetence following ascending aortic dilatation represent other serious cardiovascular complications. However, cardiac failure as a consequence of myocarditis is rarely reported, principally in single case reports or in autopsy studies...
April 4, 2017: Seminars in Arthritis and Rheumatism
https://www.readbyqxmd.com/read/28488055/-choosing-wisely-recommendations-in-nephrology
#4
REVIEW
J Galle, J Floege
The German Society of Internal Medicine ("Deutsche Gesellschaft für Innere Medizin", DGIM) founded the Choosing wisely initiative in order to address diagnostic and therapeutic procedures that are frequently inappropriately applied, whether this be in terms of over-, under-, or misuse of health services. The German Society of Nephrology ("Deutsche Gesellschaft für Nephrologie," DGfN) strongly supports the initiative and has contributed five positive and five negative recommendations. These ten recommendations are discussed in the current publication...
May 9, 2017: Der Internist
https://www.readbyqxmd.com/read/28486870/long-term-cardiac-morbidity-and-mortality-in-patients-with-aortic-valve-disease-following-liver-transplantation-a-case-matching-study
#5
Ramona Nicolau-Raducu, Thomas Marshall, Hamang Patel, Kelly Ural, Joseph Koveleskie, Susan Smith, Donald Ganier, Bryan Evans, Brian Fish, William Daly, Ari J Cohen, George Loss, Amjad Bokhari, Bobby Nossaman
INTRODUCTION: This retrospective study examined the role of aortic valve (AV) disease in patients who underwent orthotopic liver transplantation (OLT) to determine the incidence of postoperative cardiac morbidity and mortality when compared with a matched control group without AV disease. METHODS: Patients were included in the AV group if diagnosed with aortic stenosis (AS) or aortic regurgitation or had received AV replacement prior to OLT. The AV group (n = 53) was matched to a control group (n = 212) with the following preoperative variables: type of organ transplanted, age, gender, race, body mass index, MELD, redo-transplantation, preoperative renal replacement therapy, nonalcoholic steatohepatitis, viral hepatitis, diabetes, and coronary artery disease...
May 1, 2017: Seminars in Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/28486233/renal-autotransplantation-with-autologous-saphenous-vein-graft-in-a-patient-with-takayasu-arteritis-and-existing-renal-artery-stent-in-her-solitary-kidney
#6
Hakan Bahadir Haberal, Senol Tonyali, Bora Peynircioğlu, Mustafa Arici, Metin Demircin, Fazıl Tuncay Aki
Takayasu arteritis is a disease that results in the granulomatous inflammation of large vessel walls. Takayasu arteritis is generally observed in young females during the second or third decades of life. This disease is treated by the revascularization of the affected organs either by surgery or by endovascular interventions. In this study, we present a case where renal autotransplantation was performed on a lady with an autologous saphenous vein graft subsequent to numerous previous endovascular interventions for her solitary kidney due to Takayasu arteritis-induced renal artery stenosis...
May 10, 2017: Urologia Internationalis
https://www.readbyqxmd.com/read/28479775/surgical-revascularization-of-bilateral-renal-artery-stenosis-due-to-fibromuscular-dysplasia
#7
Chandan Phukan, Arun J P George, J Chandrasingh, Antony Devasia
Fibromuscular dysplasia (FMD) is a noninflammatory disease affecting small- and medium-sized arteries of the renal and the carotids. It affects the renal arteries in nearly 60%-75% cases. The primary clinical manifestation of renal FMD is hypertension. Medial fibroplasia represents the most common dysplastic lesion. We report two cases who presented with hypertension and renal insufficiency and on evaluation was found to have bilateral renal artery stenosis. Stenting of the renal vessels was not possible due to the narrowed caliber of the vessel and inability to cannulate the renal arteries...
April 2017: Urology Annals
https://www.readbyqxmd.com/read/28471586/supravalvular-aortic-and-renal-artery-stenosis-in-childhood-is-there-a-common-denominator
#8
Galit Pomeranz, Avishalom Pomeranz, Alexandra Osadchy, Yigal Griton, Ze'ev Korzets
No abstract text is available yet for this article.
August 2016: Israel Medical Association Journal: IMAJ
https://www.readbyqxmd.com/read/28470403/the-capability-of-inflow-inversion-recovery-magnetic-resonance-compared-to-contrast-enhanced-magnetic-resonance-in-renal-artery-angiography
#9
Xueqin Xu, Xiaozhu Lin, Juan Huang, Zhaocheng Pan, Xiaolei Zhu, Kemin Chen, Chi-Shing Zee, Fuhua Yan
PURPOSE: To assess the capability of inflow inversion recovery (IFIR) magnetic resonance angiography (MRA), compared with contrast-enhanced MRA (CE-MRA) as reference standard, in evaluating renal artery stenosis (RAS). METHODS: Seventy-two subjects were examined by IFIR MRA with respiratory-gated, prior to CE-MRA with a 1.5-T scanner. Two readers evaluated the quality of IFIR MRA images and renal artery depiction on artery-by-artery basis. The agreement of two methods to assess RAS was analyzed using the Kappa test...
May 3, 2017: Abdominal Radiology
https://www.readbyqxmd.com/read/28467527/association-of-transcatheter-aortic-valve-replacement-with-30-day-renal-function-and-1-year-outcomes-among-patients-presenting-with-compromised-baseline-renal-function-experience-from-the-partner-1-trial-and-registry
#10
Nirat Beohar, Darshan Doshi, Vinod Thourani, Hanna Jensen, Susheel Kodali, Feifan Zhang, Yiran Zhang, Charles Davidson, Patrick McCarthy, Michael Mack, Samir Kapadia, Martin Leon, Ajay Kirtane
Importance: The frequency of baseline renal impairment among high-risk and inoperable patients with severe aortic stenosis undergoing a transcatheter aortic valve replacement (TAVR) and the effect of TAVR on subsequent renal function are, to our knowledge, unknown. Objective: To determine the effect of TAVR among patients with baseline renal impairment. Design, Setting, and Participants: This substudy of patients with baseline renal impairment (estimated glomerular filtration rate [eGFR] ≤ 60 mL/min) and paired baseline and 30-day measures of renal function undergoing TAVR in the PARTNER 1 trial and continued access registries was conducted in 25 centers in the United States and Canada...
May 3, 2017: JAMA Cardiology
https://www.readbyqxmd.com/read/28466753/non-compressible-abis-are-associated-with-an-increased-risk-of-major-amputation-and-major-adverse-cardiovascular-events-in-patients-with-critical-limb-ischemia
#11
Gagan D Singh, Ehrin J Armstrong, Stephen W Waldo, Bejan Alvandi, Ellen Brinza, Justin Hildebrand, Ezra A Amsterdam, Misty D Humphries, John R Laird
Ankle-brachial indices (ABIs) are important for the assessment of disease burden among patients with peripheral artery disease. Although low values have been associated with adverse clinical outcomes, the association between non-compressible ABI (ncABI) and clinical outcome has not been evaluated among patients with critical limb ischemia (CLI). The present study sought to compare the clinical characteristics, angiographic findings and clinical outcomes of those with compressible (cABI) and ncABI among patients with CLI...
March 1, 2017: Vascular Medicine
https://www.readbyqxmd.com/read/28463859/adiponectin-lipids-and-atherosclerosis
#12
Niki Katsiki, Christos Mantzoros, Dimitri P Mikhailidis
PURPOSE OF REVIEW: Adiponectin is an adipokine with anti-inflammatory, antioxidant, antiatherogenic, pro-angiogenic, vasoprotective and insulin-sensitizing properties. Several factors may influence adiponectin levels, such as genetic polymorphisms, obesity / body fat distribution, diet and exercise as well as cardiovascular risk factors such as sleep deprivation and smoking as well as medications. Adiponectin has been proposed as a potential prognostic biomarker and a therapeutic target in patients with cardiometabolic diseases...
April 29, 2017: Current Opinion in Lipidology
https://www.readbyqxmd.com/read/28461553/autologous-mesenchymal-stem-cells-increase-cortical-perfusion-in-renovascular-disease
#13
Ahmed Saad, Allan B Dietz, Sandra M S Herrmann, LaTonya J Hickson, James F Glockner, Michael A McKusick, Sanjay Misra, Haraldur Bjarnason, Adam S Armstrong, Dennis A Gastineau, Lilach O Lerman, Stephen C Textor
Atherosclerotic renovascular disease (RVD) reduces renal blood flow (RBF) and GFR and accelerates poststenotic kidney (STK) tissue injury. Preclinical studies indicate that mesenchymal stem cells (MSCs) can stimulate angiogenesis and modify immune function in experimental RVD. We assessed the safety and efficacy of adding intra-arterial autologous adipose-derived MSCs into STK to standardized medical treatment in human subjects without revascularization. The intervention group (n=14) received a single infusion of MSC (1...
May 1, 2017: Journal of the American Society of Nephrology: JASN
https://www.readbyqxmd.com/read/28458879/rare-cause-of-massive-lower-gastrointestinal-bleeding-due-to-primary-isolated-ilio-rectal-fistula
#14
Nuttapon Arpornsujaritkun, Chairat Supsamutchai, Wiwat Thirapanich, Pitichote Hiranyatheb, Namsiri Biadul
Massive lower gastrointestinal from primary isolated ilio-rectal fistula is a rare condition and difficult to diagnosis and emergency surgery for this situation has a high mortality rate. This report describes a successful operation in an 88-year-old man at present with massive lower gastrointestinal hemorrhage from ilio-rectal fistula and hypovolemic shock. Underlying diseases are prostate cancer, hypertension, dyslipidemia, aortic stenosis, mitral valve stenosis and chronic renal disease. Operative treatment is to explore laparotomy with internal iliac artery ligation and rectal resection...
April 2017: Journal of Surgical Case Reports
https://www.readbyqxmd.com/read/28457423/mycotic-pseudoaneurysm-after-kidney-transplantation-two-case-reports
#15
A Ministro, T Ferreira, L Batista, A Santana, N Alves, J Guerra, J Fernandes E Fernandes
BACKGROUND: Vascular complications after kidney transplantation may cause allograft loss. Here, we describe 2 patients with extrarenal mycotic pseudoaneurysm after kidney transplantation. PATIENTS: Patient 1 was a 54-year-old man who developed pseudoaneurysm 60 days after transplantation, and patient 2 was a 48-year-old woman who was diagnosed with a pseudoaneurysm 5 months after transplantation. RESULTS: Patient 1 had a deceased-donor kidney transplant with end-to-side external iliac arterial anastomosis that was reconstructed 8 days after transplantation owing to rupture and major bleeding...
May 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/28454636/carotid-artery-disease-and-perioperative-stroke-risk-after-surgical-aortic-valve-replacement-a-nationwide-inpatient-sample-analysis
#16
Reshmi Udesh, Amol Mehta, Thomas Gleason, Parthasarathy D Thirumala
To study the role of carotid stenosis (CS) and cerebrovascular disease as independent risk factors for perioperative stroke following surgical aortic valve replacement (SAVR). The National Inpatient Sample (NIS) database was used for our study. All patients who underwent SAVR from 1999 to 2011 were identified using ICD-9 codes. Univariate and multivariate analysis of baseline characteristics, Elixhauser comorbidities and other covariates were examined to identify independent predictors of perioperative strokes following SAVR...
April 25, 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/28453796/descendo-bifemoral-bypass-grafting-and-renal-artery-revascularization-to-treat-complex-obliterative-arteriopathy
#17
Stoyan Kondov, Bartosz Rylski, Fabian Alexander Kari, Rika Wobser, Simon Leschka, Matthias Siepe, Friedhelm Beyersdorf, Martin Czerny
OBJECTIVES: Our goal was to describe a new standardized approach in patients with extensive obliterative arteriopathy aimed at distal revascularization and surgical kidney recruitment via descendo-bifemoral bypass grafting and renal artery revascularization. METHODS: Three patients with Leriche's syndrome and either a compromised single kidney or unilateral significant renal artery stenosis were treated with a standardized surgical approach, restoration of distal perfusion via descendo-bifemoral bypass with synchronous ( n  = 2) left-sided renal artery revascularization or metachronous ( n  = 1) right-sided renal artery revascularization...
May 1, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/28453557/perivascular-radiofrequency-renal-denervation-lowers-blood-pressure-and-ameliorates-cardiorenal-fibrosis-in-spontaneously-hypertensive-rats
#18
Shujie Wei, Dan Li, Yan Zhang, Linan Su, Yunrong Zhang, Qiang Wang, Dachun Yang, De Li, Yongjian Yang, Shuangtao Ma
BACKGROUND: Catheter-based renal denervation (RDN) is a promising approach to treat hypertension, but innervation patterns limit the response to endovascular RDN and the post-procedural renal artery narrowing or stenosis questions the endovascular ablation strategy. This study was performed to investigate the anti-hypertensive and target organ protective effects of perivascular RDN in spontaneously hypertensive rats (SHR). METHODS: SHR and normotensive Wistar-Kyoto (WKY) rats were divided into sham group (n = 10), radiofrequency ablation group (n = 20) in which rats received bilateral perivascular ablation with radiofrequency energy (2 watts), and chemical (10% phenol in 95% ethanol) ablation group (n = 12)...
2017: PloS One
https://www.readbyqxmd.com/read/28441700/ultrasound-based-renal-sympathetic-denervation-for-the-treatment-of-therapy-resistant-hypertension-a-single-center-experience
#19
Karl Fengler, Robert Höllriegel, Thomas Okon, Thomas Stiermaier, Karl-Philipp Rommel, Stephan Blazek, Christian Besler, Max von Roeder, Martin Petzold, Gerhard Schuler, Philipp Lurz
INTRODUCTION: The effectiveness of renal sympathetic denervation (RDN) as a treatment for therapy-resistant hypertension has been doubted as the Simplicity-HTN-3 trial was unable to show any treatment benefit over sham procedure. This might partly be explained by a high procedural variability in treatment with radiofrequency-based catheters. Recently, newer systems for RDN, like ultrasound-based devices, have been introduced into practice. To date however, data on their effectiveness for the treatment of resistant hypertension are scarce...
June 2017: Journal of Hypertension
https://www.readbyqxmd.com/read/28434235/recirculation-zone-length-in-renal-artery-is-affected-by-flow-spirality-and-renal-to-aorta-flow-ratio
#20
Ashkan Javadzadegan, David Fulker, Tracie Barber
Haemodynamic perturbations such as flow recirculation zones play a key role in progression and development of renal artery stenosis, which typically originate at the aorta-renal bifurcation. The spiral nature of aortic blood flow, division of aortic blood flow in renal artery as well as the exercise conditions have been shown to alter the haemodynamics in both positive and negative ways. This study focuses on the combinative effects of spiral component of blood flow, renal-to-aorta flow ratio and the exercise conditions on the size and distribution of recirculation zones in renal branches using computational fluid dynamics technique...
April 24, 2017: Computer Methods in Biomechanics and Biomedical Engineering
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