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Renal artery stenosis

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https://www.readbyqxmd.com/read/28648650/planning-execution-and-follow-up-for-endovascular-aortic-aneurysm-repair-using-a-highly-restrictive-iodinated-contrast-protocol-in-patients-with-severe-renal-disease
#1
E Gallitto, G L Faggioli, M Gargiulo, A Freyrie, R Pini, C Mascoli, S Ancetti, V Vento, A Stella
BACKGROUND: The cumulative amount of iodinated-contrast-medium necessary for EVAR planning, operative procedure and subsequent follow-up is a threat for the onset of end stage renal disease in patients with pre-operative impaired kidney function. Purpose of this study is to describe a mini-invasive approach aimed to minimize the exposure of these patients to iodinated-contrast-medium and the subsequent risk of renal function worsening. METHODS: From 2012 to 2015, all patients with abdominal aortic aneurysm (AAA) at high-surgical risk and fit for standard endovascular repair (simple aortic-iliac anatomy: proximal and distal neck length ≥15mm, no severe angulation), underwent EVAR through the following "near-zero contrast" approach, if their glomerular filtration rate (GFR) was <30 mL/min: pre-operative planning was performed by non-contrast enhanced computed tomography (CT) and duplex-ultrasound (DU); the origin of renal/hypogastric arteries and aortic bifurcation was evaluated and matched with vertebral bone landmarks and the endograft deployed accordingly, using < 20cc of isotonic iodinate-contrast-medium and contrast-enhancement-DU (CEUS)...
June 22, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28646466/effects-of-catheter-based-renal-denervation-on-heart-failure-with-reduced-ejection-fraction-a-systematic-review-and-meta-analysis
#2
REVIEW
Hidekatsu Fukuta, Toshihiko Goto, Kazuaki Wakami, Nobuyuki Ohte
Despite the recent advances in the management of heart failure, the mortality of heart failure patients remains high. It is of urgent need to develop new therapy for heart failure. Heart failure is characterized by increased sympathetic activity, and chronic sympathetic activation is involved in the maintenance of the pathological state. Catheter-based renal denervation (RDN) has emerged as an invasive but safe approach that can reduce sympathetic activation. Studies have reported inconsistent results regarding the effect of RDN in heart failure patients due to limited power with small sample sizes...
June 24, 2017: Heart Failure Reviews
https://www.readbyqxmd.com/read/28621587/treatment-of-severe-hypertension-in-a-14-year-old-child-successful-blood-pressure-control-with-additive-administration-of-captopril-an-angiotensin-converting-enzyme-inhibitor-in-a-patient-with-bilateral-renovascular-hypertension
#3
Xin Zhang, Ying Xu, Xiaoping Chen, Si Wang, Xinran Li, Xin Yan
We report a 14-year-old boy with recurrent episodes of headache caused by uncontrolled hypertension. The diagnosis of renovascular hypertension due to Takaysu arteritis (TA) was made based on an increase in erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) and computed tomography (CT) image of bilateral renal artery stenosis was taken. Renal scintigraphy revealed normal perfusion and function of the right kidney and severe reduction of the perfusion and function of the left kidney. Careful drug adjustments significantly improved but did not fully control the blood pressure (BP); further, angioplasty, which showed almost occlusion of the left renal artery opening and the minor narrowing of the right renal artery, failed to regain sufficient BP control...
June 16, 2017: Clinical and Experimental Hypertension: CHE
https://www.readbyqxmd.com/read/28616618/flash-pulmonary-edema-a-rare-cause-and-possible-mechanisms
#4
Tolga Cimen, Engin Algul, Tolga Han Efe, Hamza Sunman, Ekrem Yeter
Flash pulmonary edema frequently develop in case of bilateral renal artery stenosis and unilateral renal artery stenosis with functional solitary kidney. In some rare cases, unilateral renal artery stenosis with bilaterally functional kidneys may also lead to flash pulmonary edema. Here, we present a case of flash pulmonary edema caused by accessory renal artery stenosis. To our knowledge, it is the first case reported in the literature.
June 2017: Turkish Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28612007/erdheim-chester-disease-presenting-with-secondary-hypertension-as-a-result-of-bilateral-proximal-renal-artery-stenosis-a-case-report
#5
Farid Arman, Hania Shakeri, Niloofar Nobakht, Anjay Rastogi, Mohammad Kamgar
Erdheim-Chester disease (ECD) is a rare, non-Langerhans cell histiocytosis presenting most commonly with bone and central nervous system symptoms, including but not limited to bone pain and diabetes insipidus. We present a known case of ECD, which was referred for secondary hypertension workup and diagnosed with severe, proximal, bilateral renal artery stenosis.
May 2017: Case Reports in Nephrology and Dialysis
https://www.readbyqxmd.com/read/28594847/kidney-volume-to-gfr-ratio-predicts-functional-improvement-after-revascularization-in-atheromatous-renal-artery-stenosis
#6
Constantina Chrysochou, Darren Green, James Ritchie, David L Buckley, Philip A Kalra
BACKGROUND: Randomized controlled trials (RCT) have shown no overall benefit of renal revascularization in atherosclerotic renovascular disease (ARVD). However, 25% of patients demonstrate improvement in renal function. We used the ratio of magnetic resonance parenchymal volume (PV) to isotopic single kidney glomerular filtration rate (isoSKGFR) ratio as our method to prospectively identify "improvers" before revascularization. METHODS: Patients with renal artery stenosis who were due revascularization were recruited alongside non-ARVD hypertensive CKD controls...
2017: PloS One
https://www.readbyqxmd.com/read/28594810/kidney-injury-secondary-to-endovascular-treatment-of-renal-artery-stenosis
#7
N Fatic, I Kuzmanovic, D Markovic, L Davidovic, M Vukovic, D Kostić
In this paper, we present a case of kidney injury as a complication of renal artery angioplasty in a 54-year-old female patient that suffered from resistant renovascular hypertension. This case emphasises the unpredictable nature of endovascular procedures, the need for careful post-procedure evaluation and the role of 'old fashioned' surgical techniques in resolving complications of endovascular procedures.
2017: Angiologii︠a︡ i Sosudistai︠a︡ Khirurgii︠a︡, Angiology and Vascular Surgery
https://www.readbyqxmd.com/read/28590771/non-contrast-mr-angiography-using-three-dimensional-balanced-steady-state-free-precession-imaging-for-evaluation-of-stenosis-in-the-celiac-trunk-and-superior-mesenteric-artery-a-preliminary-comparative-study-with-computed-tomography-angiography
#8
Patricia Prando Cardia, Thiago José Penachim, Adilson Prando, Ulysses S Torres, Giuseppe D'Ippólito
OBJECTIVES: Although non-contrast magnetic resonance angiography (NC-MRA) is well established for the evaluation of renal artery stenosis, its usefulness in the evaluation of other abdominal aortic branches remains to be studied. This study aimed at evaluating the image quality and diagnostic accuracy of NC-MRA using a three-dimensional balanced steady-state free precession sequence (bSSFP) in identifying stenosis in the celiac trunk and superior mesenteric artery as compared to computed tomography angiography (CTA) as the reference standard...
June 7, 2017: British Journal of Radiology
https://www.readbyqxmd.com/read/28587578/extra-vascular-findings-in-patients-undergoing-magnetic-resonance-angiography-of-the-abdomen-pelvis-and-lower-extremities-a-retrospective-study-of-352-patients
#9
Jan M Sohns, Jan Menke, Leonard Bergau, Bernhard G Weiss, Sebastian Schmuck, Desiree Weiberg, Wieland Staab, Thorsten Derlin, Marc Dorenkamp, Christian Sohns
Background The aim of this study was to assess the prevalence and clinical significance of extra-vascular findings in patients undergoing magnetic resonance angiography of the abdomen, pelvis and lower extremities. Materials and methods Three hundred fifty-two patients underwent abdominal, pelvic and lower extremity 1.5 T magnetic resonance angiography. Clinically relevant vascular and extra-vascular findings were identified. Relevant vascular findings were classified as stenosis, occlusion, aneurysm, sclerosis, dissection or vasculitis...
January 1, 2017: Vascular
https://www.readbyqxmd.com/read/28587369/efficacy-and-indications-of-transradial-and-transfemoral-approaches-for-peripheral-artery-stent-implantation
#10
Peng Chen, Huijie Li, Chunyu Zeng, Yuqiang Fang, Weibin Shi, Xiaoqun Zhang, Chengming Yang
The transradial approach (TRA) has become an attractive alternative to the transfemoral approach (TFA) in percutaneous coronary intervention. To date, however, these two approaches have not been systematically compared in various percutaneous peripheral artery interventions (PPAIs). In the present study 258 patients with peripheral artery disease that underwent PPAI via the TRA (n=75) or the TFA (n=183) were analyzed. Clinical factors and outcomes in these two groups were compared. The puncture time was significantly longer (P<0...
June 2017: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/28584589/computerized-tomography-use-in-williams-beuren-syndrome-aortopathy
#11
Neale Nicola Kalis, Leena Khalifa Sulaibikh, Saud Rashid Al Amer, Haya Yousif Al Amer
Williams-Beuren syndrome is a multisystem genetic disorder caused by hemizygous deletion on chromosome 7q11.23, encompassing about 28 genes including the elastin gene, ELN. Cardiovascular abnormalities are frequent and are related to elastin insufficiency. These abnormalities include supravalvular aortic stenosis (SVAS) in 70% of case, pulmonic valve stenosis, and renal artery stenosis. Definitive therapy for supravalvar aortic stenosis consists of surgical correction of the arteriopathies. Outcomes after surgical correction of SVAS depend on the extent of the arteriopathy and the presence of other associated lesions...
January 2017: Heart Views: the Official Journal of the Gulf Heart Association
https://www.readbyqxmd.com/read/28583646/transplant-renal-artery-stenosis-evaluation-with-contrast-enhanced-ultrasound
#12
Fu-Shun Pan, Ming Liu, Jia Luo, Wen-Shuo Tian, Jin-Yu Liang, Ming Xu, Yan-Ling Zheng, Xiao-Yan Xie
OBJECTIVE: To assess the efficacy of contrast-enhanced ultrasound (CEUS) in depicting transplant renal artery stenosis (TRAS). MATERIALS AND METHODS: Seventy-eight patients (56 men and 22 women; aged 36±12.2years) who were suspected of TRAS due to either Doppler ultrasound (DUS) abnormalities or difficult control of blood pressure and/or persistent deterioration of renal function were enrolled to perform CEUS. The reference standard for the TRAS diagnoses was computed tomography angiography (CTA)...
May 2017: European Journal of Radiology
https://www.readbyqxmd.com/read/28575888/renal-involvement-in-2-siblings-with-cockayne-syndrome
#13
Amel Ben Chehida, Narjess Ghali, Rim Ben Abdelaziz, Fatma Ben Moussa, Neji Tebib
Renal involvement in Cockayne syndrome is rare and its pathogenesis is yet unknown. We report herein 2 cases (siblings) with Cockayne syndrome type A confirmed by biochemical and molecular assays. The first case was a 13-year-old girl who presented with nephritic syndrome and a rapidly progressive kidney failure. Her younger sister, 7 years old, exhibited hypertension, hyperfiltration, and microalbuminuria. She had hyperreninemia and hyperaldosteronemia without kidney failure or renal arterial stenosis. Renal biopsy, performed the older sister, revealed cystic focal segmental glomerulosclerosis, arteriosclerosis, tubulointerstitial fibrosis, and tubular atrophy...
May 2017: Iranian Journal of Kidney Diseases
https://www.readbyqxmd.com/read/28574637/efficacy-and-safety-of-gadobutrol-enhanced-mra-of-the-renal-arteries-results-from-grams-gadobutrol-enhanced-renal-artery-mra-study-a-prospective-intraindividual-multicenter-phase-3-blinded-study
#14
Kelly E Fabrega-Foster, Sheela Agarwal, Neda Rastegar, Daniel Haverstock, Jacob M Agris, Ihab R Kamel
PURPOSE: To compare the performance of magnetic resonance angiography (MRA) with 1M gadobutrol, a high relaxivity macrocyclic contrast agent, to 2D time-of-flight MRA (ToF-MRA) using computed tomographic angiography (CTA) as the standard of reference. Primary objectives were evaluation for superiority of structural delineation and noninferiority for detection and exclusion of clinically significant disease. MATERIALS AND METHODS: In all, 315 subjects underwent unenhanced and contrast-enhanced MRA with 1M gadobutrol (CE-MRA) and were scanned with 1...
June 2, 2017: Journal of Magnetic Resonance Imaging: JMRI
https://www.readbyqxmd.com/read/28562413/renal-adiposity-confounds-quantitative-assessment-of-markers-of-renal-diffusion-with-mri-a-proposed-correction-method
#15
Behzad Ebrahimi, Ahmed Saad, Kai Jiang, Christopher M Ferguson, Hui Tang, John R Woollard, James F Glockner, Stephen C Textor, Lilach O Lerman
OBJECTIVES: Recent studies have indicated that excessive fat may confound assessment of diffusion in organs with high fat content, such as the liver and breast. However, the extent of this effect in the kidney, which is not considered a major fat deposition site, remains unclear. This study tested the hypothesis that renal fat may impact diffusion-weighted imaging (DWI) parameters, and proposes a 3-compartment model (TCM) to circumvent this effect. METHODS: Using computer simulations, we investigated the effect of fat on assessment of apparent diffusion coefficient (ADC), intravoxel incoherent motion (IVIM), and TCM-derived pure-diffusivity...
May 29, 2017: Investigative Radiology
https://www.readbyqxmd.com/read/28560752/selective-embolization-therapy-for-intrarenal-artery-stenosis-causing-renovascular-hypertension-efficacy-and-follow-up-renal-imaging
#16
Eikan Mishima, Takehiro Suzuki, Kazumasa Seiji, Yasutoshi Akiyama, Hideki Ota, Junichiro Hashimoto, Kei Takase, Takaaki Abe, Sadayoshi Ito
We report the case of a young woman treated with selective renal embolization for renovascular hypertension caused by intrarenal artery stenosis and show follow-up imaging of the treated kidney. An 18-year-old woman had renin-dependent hypertension with intrarenal artery stenosis caused by fibromuscular dysplasia. A middle branch artery was nearly occluded, resulting in segmental renal ischemia with excessive renin secretion. Because our angioplasty attempt for revascularization failed as a result of technical difficulty, we performed selective embolization of the diseased vessel by anhydrous ethanol...
May 30, 2017: Journal of Clinical Hypertension
https://www.readbyqxmd.com/read/28554696/-hypertension-during-takayasu-s-disease-an-algerian-single-center-experience-of-279-patients
#17
A Mammeri, R Guermaz, A Hatri, F Kessal, S Taharboucht, F Hamrour, M Ammi, S Zekri, M Brouri
INTRODUCTION: Takayasu arteritis (TA) is an uncommon large vessel arteritis. Lesions produced by the inflammatory process can be stenotic, occlusive, or aneurysmal. Vascular changes lead to the main complications, including hypertension, most often due to renal artery stenosis or, more rarely, stenosis of the suprarenal aorta. AIM OF STUDY: Our study will assess the prevalence of hypertension during TA and describe its clinical profile. MATERIAL AND METHODS: Among 279 patients with TA resulting from single center study over a period of 35 years, we collected 128 hypertensive patients...
May 26, 2017: Annales de Cardiologie et D'angéiologie
https://www.readbyqxmd.com/read/28542095/magnetization-transfer-magnetic-resonance-imaging-noninvasively-detects-renal-fibrosis-in-swine-atherosclerotic-renal-artery-stenosis-at-3-0-t
#18
Kai Jiang, Christopher M Ferguson, John R Woollard, Xiangyang Zhu, Lilach O Lerman
OBJECTIVES: Renal fibrosis is a useful biomarker for diagnosis and evaluation of therapeutic interventions of renal diseases but often requires invasive testing. Magnetization transfer magnetic resonance imaging (MT-MRI), which evaluates the presence of macromolecules, offers a noninvasive tool to probe renal fibrosis in murine renal artery stenosis (RAS) at 16.4 T. In this study, we aimed to identify appropriate imaging parameters for collagen detection at 3.0 T MRI and to test the utility of MT-MRI in measuring renal fibrosis in a swine model of atherosclerotic RAS (ARAS)...
May 24, 2017: Investigative Radiology
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
#19
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
#20
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
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