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Renal artery stenosis

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https://www.readbyqxmd.com/read/28916603/phase-2a-clinical-trial-of-mitochondrial-protection-elamipretide-during-stent-revascularization-in-patients-with-atherosclerotic-renal-artery-stenosis
#1
Ahmed Saad, Sandra M S Herrmann, Alfonso Eirin, Christopher M Ferguson, James F Glockner, Haraldur Bjarnason, Michael A McKusick, Sanjay Misra, Lilach O Lerman, Stephen C Textor
BACKGROUND: Atherosclerotic renal artery stenosis reduces renal blood flow (RBF) and amplifies stenotic kidney hypoxia. Revascularization with percutaneous transluminal renal angioplasty (PTRA) and stenting often fails to recover renal function, possibly because of ischemia/reperfusion injury developing after PTRA. Elamipretide is a mitochondrial-targeted peptide that binds to cardiolipin and stabilizes mitochondrial function. We tested the hypothesis that elamipretide plus PTRA would improve renal function, oxygenation, and RBF in patients with atherosclerotic renal artery stenosis undergoing PTRA...
September 2017: Circulation. Cardiovascular Interventions
https://www.readbyqxmd.com/read/28905547/-fibromuscular-dysplasia-and-hypertension-beyond-renal-arteries
#2
Grégoire Wuerzner, Caroline Krieger, Julie Bouchardy, Laurent Toubiana, Philippe Delmotte, Patricia Van der Niepen, Sébastien Déglise, Salah Qanadli, Michel Burnier, Lucia Mazzolai, Alexandre Persu
Fibromuscular dysplasia (FMD) is a disease associated with abnormalities of the arterial wall of medium-sized arteries. These abnormalities can lead to stenosis or less frequently to dissections or aneurysms. FMD is probably more frequent than initially thought. Nowadays, it is often a chance finding during a radiologic exam. In symptomatic cases, poor organ perfusion due to stenosis, dissection or aneurysm rupture may lead to the diagnosis. The aim of this non-systematic review illustrated with a clinical case is to present our current knowledge of FMD and to highlight the necessity of a standardized and multidisciplinary work-up to improve management of affected patients and understanding of the disease...
September 13, 2017: Revue Médicale Suisse
https://www.readbyqxmd.com/read/28904880/association-of-serum-uric-acid-level-with-coronary-artery-stenosis-severity-in-korean-end-stage-renal-disease-patients
#3
Hye Yun Jeong, Hye Jeong Cho, Sang Hoon Kim, Jun Chul Kim, Mi Jung Lee, Dong Ho Yang, So-Young Lee
BACKGROUND: Hyperuricemia is common in end-stage renal disease (ESRD) patients, and many previous studies have reported the associations between hyperuricemia and adverse cardiovascular outcomes, which are the major cause of death in such patients. We investigated the relationship between serum uric acid level and the severity of coronary stenosis in ESRD patients on maintenance hemodialysis (MHD). METHODS: Among 721 patients who started MHD treatment, 102 underwent coronary angiographic tests complaining of chest discomfort that was new at initiation of MHD...
September 2017: Kidney Research and Clinical Practice
https://www.readbyqxmd.com/read/28902735/positive-captopril-renography-without-renal-artery-stenosis-but-a-renal-cell-carcinoma
#4
Ping-Ju Hsieh, Yen-Shu Kuo, Meng-Lin Chen, Ching-Ling Lin, Hung-Yi Su
A positive captopril renography indicates that patient's hypertension is renin dependent, most commonly caused by renal artery stenosis. The authors reported a case of positive captopril renography; however, CT demonstrated that renal arteries were intact, but there was a huge chromophobe renal cell carcinoma. Renin-dependent hypertension was relieved soon after nephrectomy. It is an uncommon cause of positive captopril renography.
September 11, 2017: Clinical Nuclear Medicine
https://www.readbyqxmd.com/read/28893490/partial-renal-coverage-in-endovascular-aneurysm-repair-causes-unfavorable-renal-flow-patterns-in-an-infrarenal-aneurysm-model
#5
Lennart van de Velde, Esmé J Donselaar, Erik Groot Jebbink, Johannes T Boersen, Guillaume P R Lajoinie, Jean-Paul P M de Vries, Clark J Zeebregts, Michel Versluis, Michel M P J Reijnen
OBJECTIVE: To achieve an optimal sealing zone during endovascular aneurysm repair, the intended positioning of the proximal end of the endograft fabric should be as close as possible to the most caudal edge of the renal arteries. Some endografts exhibit a small offset between the radiopaque markers and the proximal fabric edge. Unintended partial renal artery coverage may thus occur. This study investigated the consequences of partial coverage on renal flow patterns and wall shear stress (WSS)...
September 8, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28893450/emergency-medicine-evaluation-and-management-of-the-end-stage-renal-disease-patient
#6
REVIEW
Brit Long, Alex Koyfman, Courtney M Lee
BACKGROUND: End stage renal disease (ESRD) is increasing in the U.S., and these patients demonstrate greater all-cause mortality, cardiovascular events, and hospitalization rates when compared to those with normal renal function. These patients may experience significant complications associated with loss of renal function and dialysis. OBJECTIVE: This review evaluates complications of ESRD including cardiopulmonary, neurologic, infectious disease, vascular, and access site complications, as well as medication use in this population...
September 5, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28885208/the-diagnostic-value-of-contrast-enhanced-ultrasound-ceus-as-a-new-technique-for-imaging-of-vascular-complications-in-renal-transplants-compared-to-standard-imaging-modalities
#7
K Mueller-Peltzer, J Rübenthaler, M Fischereder, M Reiser, D-A Clevert
BACKGROUND: Vascular complications in renal transplant patients are a well-known issue in post transplant patient care. If malfunctioning of the renal transplant is suspected to be caused by vascular complications an early diagnosis and therapy is required to maintain the renal transplant. Computed tomography (CT), digital substraction angiography (DSA) and radioisotope renography are the gold standard imaging modalities to diagnose vascular complications. OBJECTIVE: To analyse the sensitivity and specificity of contrast-enhanced ultrasound (CEUS) in comparison to the standard imaging modalities CT, DSA and radioisotope renography in the diagnosis of vascular complications in renal transplant patients...
September 4, 2017: Clinical Hemorheology and Microcirculation
https://www.readbyqxmd.com/read/28865484/renal-ultrasound-provides-low-utility-in-evaluating-cardiac-surgery-associated-acute-kidney-injury
#8
Allen Young, Todd Crawford, Alejandro Suarez Pierre, J Trent Magruder, Charles Fraser, John Conte, Glenn Whitman, Christopher Sciortino
BACKGROUND: Renal ultrasonography is part of the algorithm in assessing acute kidney injury (AKI). The purpose of this study was to assess the clinical utility of renal US in postoperative cardiac patients who develop AKI. METHODS: We conducted a retrospective study of 90 postoperative cardiac surgery patients at a single institution from 1/19/2010 to 3/19/2016 who underwent renal US for AKI. We reviewed provider documentation to determine whether renal US changed management...
September 2, 2017: Journal of Cardiothoracic Surgery
https://www.readbyqxmd.com/read/28863945/the-renal-artery-is-involved-in-chinese-takayasu-s-arteritis-patients
#9
Zhe Chen, Jing Li, Yunjiao Yang, Hongchao Li, Jiuliang Zhao, Fei Sun, Mengtao Li, Xinping Tian, Xiaofeng Zeng
Takayasu's arteritis is a rare systemic vasculitis mainly affecting the aorta and its major branches. Previous studies have suggested that almost half of the Asian Takayasu's patients have renal artery involvement. However, due to the rarity of the disease, little is known about renal artery involvement in Chinese Takayasu's arteritis patients. Here, we retrospectively reviewed and analyzed 411 patients diagnosed with Takayasu's arteritis in our center to explore the clinical features of renal artery involvement in this group of patients...
August 30, 2017: Kidney International
https://www.readbyqxmd.com/read/28858538/screening-for-transplant-renal-artery-stenosis-ultrasound-based-stenosis-probability-stratification
#10
Ghaneh Fananapazir, John P McGahan, Michael T Corwin, Susan L Stewart, Catherine T Vu, Luke Wright, Christoph Troppmann
OBJECTIVE: The objective of our study was to evaluate which spectral Doppler ultrasound parameters are useful in patients with clinical concern for transplant renal artery stenosis (TRAS) and create mathematically derived prediction models that are based on these parameters. MATERIALS AND METHODS: The study subjects included 120 patients with clinical signs of renal dysfunction who had undergone ultrasound followed by angiography (either digital subtraction angiography or MR angiography) between January 2005 and December 2015...
August 31, 2017: AJR. American Journal of Roentgenology
https://www.readbyqxmd.com/read/28852489/split-renal-function-in-patients-with-unilateral-atherosclerotic-renal-artery-stenosis-effect-of-renal-angioplasty
#11
Aso Saeed, Elzbieta Nowakowska- Fortuna, Gert Jensen
OBJECTIVE: To evaluate the effect of percutaneous transluminal renal angioplasty (PTRA) on split renal function (SRF) in patients with unilateral atherosclerotic renal artery stenosis (ARAS). METHODS: We performed a retrospective analysis of all consecutively examined patients at our centre with significant ARAS undergoing PTRA during 2002-07. A significant ARAS was defined as a lesion with a trans-stenotic mean arterial pressure gradient of at least 10 mmHg or a diameter stenosis >50% on angiography...
August 2017: Clinical Kidney Journal
https://www.readbyqxmd.com/read/28852488/revisiting-angioplasty-for-renovascular-hypertension
#12
Alan A Sag, Mehmet Kanbay
Following contemporary trends in arterial endovascular therapy of the lower extremities, recent major trials in anti-hypertensive renovascular revascularization have focused on outcomes after primary stenting of the renal artery. Angioplasty-only therapy has not been studied in a major trial since the year 2000. As such, the current study by Saeed et al. presents an updated data set on the technique with one unique aspect: patients underwent post-procedural physiologic scintigraphy to document the effects of unilateral intervention in patients with two kidneys...
August 2017: Clinical Kidney Journal
https://www.readbyqxmd.com/read/28836554/outcomes-of-chimney-and-or-periscope-techniques-in-the-endovascular-management-of-complex-aortic-pathologies
#13
Zhi-Yuan Wu, Zuo-Guan Chen, Li Ma, Yong-Peng Diao, Yue-Xin Chen, Chang-Wei Liu, Yue-Hong Zheng, Bao Liu, Yong-Jun Li
BACKGROUND: The chimney/periscope technique has been used to address complex aortic pathologies. This study aimed to report the outcomes and experiences of chimney and/or periscope grafts (CPGs) used in the endovascular management of complex aortic pathologies. METHODS: Twenty-two patients with complex aortic pathologies were retrospectively studied from January 2013 to August 2016 in two vascular centers of teaching hospitals. All patients were diagnosed using computed tomography angiography (CTA)...
September 5, 2017: Chinese Medical Journal
https://www.readbyqxmd.com/read/28836464/flow-visualisation-study-of-spiral-flow-in-the-aorta-renal-bifurcation
#14
David Fulker, Ashkan Javadzadegan, Zuming Li, Tracie Barber
The aim of this study was to analyse the flow dynamics in an idealised model of the aorta-renal bifurcation using flow visualisation, with a particular focus on the effect of aorta-to-renal flow ratio and flow spirality. The recirculation length was longest when there was low flow in the renal artery and smaller in the presence of spiral flow. The results also indicate that patients without spiral flow or who have low flow in the renal artery due to the presence of stenosis may be susceptible to heightened development of atherosclerotic lesions...
August 24, 2017: Computer Methods in Biomechanics and Biomedical Engineering
https://www.readbyqxmd.com/read/28828679/transcatheter-aortic-valve-implantation-in-patients-with-a-reduced-left-ventricular-ejection-fraction-a-single-centre-experience-in-2000-patients-tavik-registry
#15
Gerhard Schymik, Panagiotis Tzamalis, Valentin Herzberger, Jens Bergmann, Peter Bramlage, Alexander Würth, Lars Oliver Conzelmann, Armin Luik, Holger Schröfel
BACKGROUND: Previous studies into the effect of a reduced left ventricular ejection fraction (EF) on the short- and long-term prognosis of patients undergoing transcatheter aortic valve implantation (TAVI) have reported conflicting findings. We analysed data from the Karlsruhe TAVI registry with the aim of addressing this question. METHODS AND RESULTS: Patients with aortic stenosis undergoing TAVI were divided into sub-groups according to EF: severely reduced (<30%; n = 109), reduced (≥30 and ≤40%; n = 201), and mid-range/preserved (>40%; n = 1690)...
August 21, 2017: Clinical Research in Cardiology: Official Journal of the German Cardiac Society
https://www.readbyqxmd.com/read/28818859/renal-denervation-suppresses-coronary-hyperconstricting-responses-after-drug-eluting-stent-implantation-in-pigs-in-vivo-through-the-kidney-brain-heart-axis
#16
Hironori Uzuka, Yasuharu Matsumoto, Kensuke Nishimiya, Kazuma Ohyama, Hideaki Suzuki, Hirokazu Amamizu, Susumu Morosawa, Michinori Hirano, Tomohiko Shindo, Yoku Kikuchi, Kiyotaka Hao, Takashi Shiroto, Kenta Ito, Jun Takahashi, Koji Fukuda, Satoshi Miyata, Yoshihito Funaki, Hatsue Ishibashi-Ueda, Satoshi Yasuda, Hiroaki Shimokawa
OBJECTIVE: Drug-eluting stent-induced coronary hyperconstricting responses remain an important issue. The adventitia harbors a variety of components that potently modulate vascular tone, including sympathetic nerve fibers (SNF) and vasa vasorum. Catheter-based renal denervation (RDN) inhibits sympathetic nerve activity. We, thus, examined whether RDN suppresses drug-eluting stent-induced coronary hyperconstricting responses, and if so, what mechanisms are involved. APPROACH AND RESULTS: Protocol 1: pigs implanted with everolimus-eluting stents into the left coronary arteries underwent coronary angiography at 1 month after implantation for assessment of coronary vasomotion and adventitial SNF formation...
August 17, 2017: Arteriosclerosis, Thrombosis, and Vascular Biology
https://www.readbyqxmd.com/read/28814591/spleno-renal-artery-transposition-in-a-solitary-functioning-kidney-for-treatment-resistant-hypertension-and-acute-kidney-injury
#17
Subash Somalanka, Fiona E Harris, Eric Chemla, Rebecca Jo Suckling, Pauline A Swift
Renal Artery Stenosis (RAS) is an important cause of treatment-resistant hypertension. Uncontrolled hypertension with RAS can cause progressive chronic kidney disease (CKD) leading to end-stage kidney disease. Therapeutic revascularisation can be helpful in appropriate circumstances where pharmaceutical intervention has failed and significant renovascular disease contributes to resistant hypertension. We present an interesting case of a Caucasian male with peripheral vasculopathy, abdominal aortic aneurysm (AAA), single functioning kidney and ostial RAS caused by stent struts from an endovascular AAA stent graft...
August 16, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28807045/a-randomized-multi-center-prospective-study-comparing-best-medical-treatment-versus-best-medical-treatment-plus-renal-artery-stenting-in-patients-with-hemodynamically-relevant-atherosclerotic-renal-artery-stenosis-radar-one-year-results-of-a-pre-maturely-terminated
#18
Thomas Zeller, Hans Krankenberg, Andrejs Erglis, Erwin Blessing, Torsten Fuss, Dierk Scheinert, Ralf Weser, Beatrix B Doerr, Wilfrid D Yollo, Joerg Radermacher
BACKGROUND: The indications for conservative "best medical treatment" (BMT) versus additional renal artery stenting are a matter of ongoing debate. The RADAR study aimed to evaluate the impact of percutaneous renal artery stenting on the impaired renal function in patients with hemodynamically significant atherosclerotic renal artery stenosis (RAS). METHODS: RADAR is an international, prospective, randomized (1:1) controlled study comparing BMT alone versus BMT plus renal artery stenting in patients with duplex sonographic hemodynamically relevant RAS...
August 14, 2017: Trials
https://www.readbyqxmd.com/read/28804237/aneurysmal-degeneration-of-the-brachial-artery-after-vascular-access-creation-surgical-treatment-results
#19
Sérgio Teixeira, Pedro Sá Pinto, Carlos Veiga, Ivone Silva, Rui Almeida
True peripheral artery aneurysms proximal to a longstanding arteriovenous fistula is a well-recognized complication. Late aneurysmal degeneration is rare. This study analyzed the characteristics, therapeutic options, and outcomes of true donor brachial artery aneurysms (DBAA) after arteriovenous fistula (AVF) for hemodialysis. We retrospectively collected the data of patients with DBAA after AVF creation, surgically repaired between January 2001 and September 2015. We excluded patients with pseudoaneurysms, anastomotic aneurysms, and infected aneurysms...
September 2017: International Journal of Angiology: Official Publication of the International College of Angiology, Inc
https://www.readbyqxmd.com/read/28803687/predictors-of-asymptomatic-radiation-induced-abdominal-atherosclerosis
#20
L Cella, R Liuzzi, P Romanelli, M Conson, V D'Avino, M Ottaviano, V Damiano, G Palmieri, R Pacelli, M Mancini
AIMS: To identify predictors of asymptomatic radiation-induced abdominal atherosclerosis in patients treated with radiotherapy and evaluated by abdominal vascular ultrasonography. MATERIALS AND METHODS: Forty-two testicular classic seminoma patients (median age 34 years, range 16-56) undergoing radical inguinal orchiectomy were analysed. Twenty-six patients underwent post-surgery radiotherapy (median total dose 25 Gy, range 25-43), two of them also received chemotherapy (CHT) and 16 patients were treated with surgery alone or by surgery followed by CHT (control group)...
August 10, 2017: Clinical Oncology: a Journal of the Royal College of Radiologists
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