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Renal artery stenosis

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https://www.readbyqxmd.com/read/28441700/ultrasound-based-renal-sympathetic-denervation-for-the-treatment-of-therapy-resistant-hypertension-a-single-center-experience
#1
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
#2
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
https://www.readbyqxmd.com/read/28431773/atypical-moyamoya-syndrome-with-brain-calcification-and-stenosis-of-abdominal-aorta-and-renal-arteries
#3
Hideki Uchikawa, Katsunori Fujii, Mayuko Fujita, Tomoko Okunushi, Naoki Shimojo
Moyamoya syndrome is a progressive cerebrovascular disease that is characterized by stenosis of the terminal portion of the internal carotid artery and its main branches, in combination with an accompanying disease. We herein describe an 8-year-old boy exhibiting transient loss of consciousness, who had recurrent seizures in infancy with progressive brain calcification. On admission, he was alert but magnetic resonance angiography showed bilateral stenosis of the whole internal carotid artery and proliferation of vascular collaterals, and brain CT revealed calcification on bilateral putamen...
April 18, 2017: Brain & Development
https://www.readbyqxmd.com/read/28424043/nutcracker-syndrome-case-report-on-the-management-of-recurrent-stenosis-after-stenting
#4
Natasha Hansraj, Abdul Hamdi, Ali Khalifeh, Eric Wise, Rajabrata Sarkar, Shahab Toursavadkohi
Nutcracker syndrome is a clinical entity leading to renal venous hypertension due to extrinsic compression of the left renal vein by the superior mesenteric artery. Current surgical therapy involves placement of an oversized renal vein stent with partial protrusion into the inferior vena cava (IVC) to relieve stenosis and prevent stent migration. Here, we present a patient with intractable pain and hematuria secondary to nutcracker syndrome who underwent left renal vein stent placement and developed recurrent symptoms due to flow-limiting kinking at the left renal hilum, with partial obstruction of the IVC from pseudointimal hyperplasia...
May 2017: Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/28405824/redo-renal-denervation-using-a%C3%A2-multi-electrode-radiofrequency-system-in-patients-with-persistent-therapy-resistant-hypertension
#5
J Daemen, L Feyz, L Van Zandvoort, N M Van Mieghem
OBJECTIVES: Renal sympathetic denervation has been studied as a potential therapeutic option for patients with therapy-resistant hypertension; however, a significant proportion of patients do not show a significant reduction in blood pressure and are classified as non-responders. The objective of the present study was to assess whether a redo renal denervation procedure increases response rates. METHODS: We present a case series of three consecutive renal denervation non-responders treated with the multi-electrode radiofrequency St...
April 12, 2017: Netherlands Heart Journal
https://www.readbyqxmd.com/read/28383849/-myocardial-infarction-on-spontaneous-coronary-dissection-caused-by-fibromuscular-dysplasia
#6
L Jackers, L Davin, B Falque, M Magnée, L Piérard
Spontaneous Coronary Artery Dissection (SCAD) is a non-traumatic and non-iatrogenic separation of the coronary arterial wall. Although uncommon, it should be suspected in any young patient with acute myocardial infarction especially without risk factor of cardiovascular disease. Early coronary angiography is essential in the diagnosis of SCAD. Fibromuscular dysplasia is a rare cause of SCAD, particularly encountered in young women. This is a nonatherosclerotic and noninflammatory vascular disease. Fibromuscular dysplasia may cause stenosis, aneurysm, dissection and / or occlusion of arteries...
October 2016: Revue Médicale de Liège
https://www.readbyqxmd.com/read/28377906/endovascular-management-of-atherosclerotic-renal-artery-stenosis-post-cardiovascular-outcomes-in-renal-atherosclerotic-lesions-era-winner-or-false-alarm
#7
REVIEW
Evridiki Karanikola, Georgios Karaolanis, George Galyfos, Emmanuel Barbaressos, Viktoria Palla, Konstantinos Filis
Renal artery stenosis (RAS) is frequently associated with severe comorbidities such as reduced renal perfusion, hypertension, and end-stage renal failure. In approximately 90% of patients, renal artery atherosclerosis is the main cause for RAS, and it is associated with an increased risk for fatal and non-fatal cardiovascular and renal complications. Endovascular management of atherosclerotic RAS (ARAS) has been recently evaluated by several randomized controlled trials that failed to demonstrate benefit of stenting...
March 2017: Vascular Specialist International
https://www.readbyqxmd.com/read/28374150/transplantation-of-bone-marrow-derived-mscs-improves-renal-function-and-na-k-atpase-activity-in-rats-with-renovascular-hypertension
#8
Rafaelle Lira, Mariana Oliveira, Marcela Martins, Caroline Silva, Simone Carvalho, Ana Carolina Stumbo, Erika Cortez, Karine Verdoorn, Marcelo Einicker-Lamas, Alessandra Thole, Laís de Carvalho
Renovascular hypertension (RVH) is a progressive disease, leading to chronic kidney disease when untreated and no specific treatment is available. Therefore, development of new therapeutic modalities is imperative. RVH is triggered by renal artery stenosis and subsequent renin-angiotensin-aldosterone system activation; it can be experimentally induced by the 2 Kidneys-1 Clip (2K1C) model. This study investigates the therapeutic potential of renal subcapsular mesenchymal stem cell (MSC) infusion in 2K1C rats...
April 3, 2017: Cell and Tissue Research
https://www.readbyqxmd.com/read/28371854/the-effect-of-revascularization-in-patients-with-anatomically-significant-atherosclerotic-renovascular-disease-presenting-with-high-risk-clinical-features
#9
Diana Vassallo, James Ritchie, Darren Green, Constantina Chrysochou, PhilipA Kalra
Background.: Patients with atherosclerotic renovascular disease (ARVD) and high-risk clinical presentations have largely been excluded from randomized controlled trials comparing renal revascularization and optimal medical therapy. Here, we explore the effect of revascularization on death, progression to end-stage kidney disease (ESKD) and cardiovascular events (CVE) in a highly selected cohort of patients with ARVD. Methods.: All patients with a radiological diagnosis of ARVD referred to our tertiary centre have been recruited into a single-centre cohort study between 1986 and 2014...
March 23, 2017: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/28361119/evaluation-of-carotid-ultrasonography-screening-among-kidney-transplant-candidates-a-single-center-retrospective-study
#10
Chad W Rossitter, Ronald B Vigo, Ahmed Osama Gaber, Joshua T Swan, Wadi N Suki
BACKGROUND: Kidney transplant candidates undergo rigorous testing prior to clearance for transplantation. Because kidney transplant candidates may be at increased risk for carotid artery stenosis because of arteriosclerosis and atherosclerosis secondary to hypertension, vascular calcification, and diabetes, carotid ultrasound is often performed with the intent of preventing a cerebrovascular accident in the perioperative or posttransplant period. To our knowledge, there has not been a study investigating the utility of screening carotid ultrasonography in pretransplant candidates...
March 2017: Transplantation Direct
https://www.readbyqxmd.com/read/28361112/5-years-experience-with-drug-eluting-and-bare-metal-stents-as-primary-intervention-in-transplant-renal-artery-stenosis
#11
Chelsea C Estrada, Muzammil Musani, Frank Darras, Heesuck Suh, Mersema T Abate, Anil Mani, Edward P Nord
BACKGROUND: Transplant renal artery stenosis (TRAS) is a common vascular complication after kidney transplantation and is associated with refractory hypertension, volume overload, and graft injury or loss. This article describes 5-year outcomes of endovascular intervention for TRAS with bare metal and drug eluting stents (DES). METHODS: We investigated, as a prospective cohort study, patient and graft outcomes after the targeted use of DES for vessel diameter less than 5 mm and bare metal stents (BMS) for vessel diameter greater than 5 mm as the primary management for TRAS...
February 2017: Transplantation Direct
https://www.readbyqxmd.com/read/28344618/patient-and-lesion-tailored-algorithm-of-endovascular-treatment-for-arterial-occlusive-disease-of-extracranial-arteries-supplying-the-brain-safety-of-the-treatment-at-30-day-follow-up
#12
Paweł Latacz, Marian Simka, Paweł Brzegowy, Piotr Janas, Marek Kazibudzki, Piotr Pieniążek, Andrzej Ochała, Tadeusz Popiela, Tomasz Mrowiecki
INTRODUCTION: Although surgical endarterectomy remains the treatment of choice for carotid artery stenosis, stenting plays an important role as an alternative treatment modality, especially in high-risk patients. The actual safety profile associated with stenting procedures is probably better than that reported by randomized controlled trials. AIM: To assess the safety of stent implantations in extracranial arteries supplying the brain, and also to identify risk factors associated with this procedure...
2017: Postępy W Kardiologii Interwencyjnej, Advances in Interventional Cardiology
https://www.readbyqxmd.com/read/28338117/endovascular-treatment-for-acute-mesenteric-ischaemia-in-a-young-woman-with-polyarterial-disease
#13
Mihai C Ober, Calin Homorodean, Dan A Tataru, Antonia E Macarie, Camelia D Ober, Dan M Olinic
BACKGROUND: Acute mesenteric ischaemia is a condition with a grim prognosis on conservative treatment. Endovascular revascularisation is a promising approach for some of these patients. CASE REPORT: We present the case of a 44-year-old woman with a history of severe arterial hypertension, left leg claudication, and overlooked symptoms of chronic mesenteric ischaemia for one year, who was admitted for severe abdominal pain for one week. Computed tomographic angiography (CTA) showed acute mesenteric ischaemia by occlusion of the coeliac trunk and the superior mesenteric artery (SMA), without bowel perforation...
March 2017: Journal of Gastrointestinal and Liver Diseases: JGLD
https://www.readbyqxmd.com/read/28332957/three-dimensional-computed-tomography-reconstruction-in-transplant-renal-artery-stenosis
#14
Xufeng Zhang, Hongwei Wang, Shuangde Liu, Jieke Yan, Xiaoli Liu, Dongsheng Xu, Chuan Tian
OBJECTIVES: Transplant renal artery stenosis is a frequently recognized complication of kidney transplant procedures. A single-center retrospective study was conducted to examine the use of 3-dimensional computed tomography reconstruction in diagnosing transplant artery stenosis. MATERIALS AND METHODS: During 2013 at our center, 86 patients underwent kidney transplant. All patients underwent ultrasonographic analyses. Patients with clinically suspected transplant renal artery stenosis were examined by 3-dimensional computed tomography reconstruction and were treated with endovascular approaches or medically managed...
March 22, 2017: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/28330437/long-term-outcomes-of-fistula-first-initiative-in-an-urban-university-hospital-is-it-still-relevant
#15
Jacques Greenberg, Senthil Jayarajan, Sridhar Reddy, Frank A Schmieder, Andrew B Roberts, Paul S van Bemmelen, Jean Lee, Eric T Choi
PURPOSE: Dialysis access failure is a major cause of morbidity in patients with end-stage renal disease. The Fistula First Breakthrough Initiative (FFBI) dictates arteriovenous fistulae (AVFs) should be preferred over arteriovenous grafts (AVGs) as first line for surgically placed accesses. The purpose of this study was to compare patency rates of surgical dialysis accesses in our mature, urban population after the FFBI. METHODS: Current dialysis patients with accesses placed between 2006 and 2011 were included...
April 2017: Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/28330433/impact-of-renal-arterial-morphology-on-fluoroscopy-time-in-chimney-endovascular-aneurysm-repair
#16
Masayuki Sugimoto, Giovanni Torsello, Konstantinos P Donas
Objectives To evaluate the impact of renal artery morphology on fluoroscopy time in chimney endovascular aneurysm repair. Methods Morphology of renal artery was retrospectively quantified in the preoperative CT angiography. Renal artery angulation, ostial diameter, severity of ostial stenosis, main renal artery length, and tortuosity were analyzed with a 3D workstation. The main measure outcome was fluoroscopic time as an indicator of complexity. Uni- and multivariate logistic regression analyses were performed to determine predictors of longer fluoroscopy...
January 1, 2017: Vascular
https://www.readbyqxmd.com/read/28326557/analysis-of-blood-flow-characteristics-in-a-model-of-a-mature-side-to-side-arteriovenous-fistula
#17
Ashkan Javadzadegan, Nay Myo Lwin, Muhammad Asyraf, Anne Simmons, Tracie Barber
The creation of an arteriovenous fistula (AVF) is a common surgical procedure in hemodialysis patients suffering from end-stage renal disease (ESRD). However, several complications may occur after surgery, including thrombosis, stenosis, and aneurysm. These complications are attributed to hemodynamics perturbations including pathophysiological wall shear stress (WSS) and flow recirculation zones. In this study, we present a computational hemodynamic analysis in a model of a mature side-to-side AVF, which is then validated by experimental measurements...
March 21, 2017: Artificial Organs
https://www.readbyqxmd.com/read/28325568/prevalence-and-management-of-systemic-hypertension-in-athletes
#18
Stefano Caselli, Antonia Vaquer Sequì, Erika Lemme, Filippo Quattrini, Alberto Milan, Flavio D'Ascenzi, Antonio Spataro, Antonio Pelliccia
The aim of the present study was to evaluate the prevalence, determinants, and clinical management of systemic hypertension in a large cohort of competitive athletes: 2,040 consecutive athletes (aged 25 ± 6 years, 64% men) underwent clinical evaluation including blood test, electrocardiogram, exercise test, echocardiography, and ophthalmic evaluation. Sixty-five athletes (3%) were identified with hypertension (men = 57; 87%) including 5 with a secondary cause (thyroid dysfunction in 3, renal artery stenosis in 1, and drug induced in 1)...
March 1, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28325445/nonlinear-model-on-pulsatile-flow-of-blood-through-a-porous-bifurcated-arterial-stenosis-in-the-presence-of-magnetic-field-and-periodic-body-acceleration
#19
R Ponalagusamy, S Priyadharshini
BACKGROUND AND OBJECTIVE: Background and Objective: The motivation of cardiovascular modeling is to understand the haemodynamic and mechanical factors in the diagnosis and treatment of cardiovascular diseases. Several investigations have been carried out by many authors to understand the flow properties of blood in modelling blood flows in the circulatory system. In the present article, the pulsatile flow of Herschel-Bulkley fluid through a bifurcated arterial stenosis in a porous medium with magnetic field and periodic body acceleration has been investigated in view of understanding the role of rheological behaviour of blood, stenotic height, bifurcation angle, magnetic field and porosity of wall in the initiation and proliferation of cardiovascular diseases...
April 2017: Computer Methods and Programs in Biomedicine
https://www.readbyqxmd.com/read/28325353/renal-artery-stenosis-when-to-revascularize-in-2017
#20
Jose D Tafur, Christopher J White
Atherosclerotic renal artery stenosis is the leading cause of secondary hypertension; it can also cause progressive renal insufficiency and cardiovascular complications such as refractory heart failure and flash pulmonary edema. Medical therapy including risk factor modification, renin-angiotensin-aldosterone system antagonists, lipid lowering agents, and antiplatelet therapy is the first line of treatment in all patients. Patients with uncontrolled renovascular hypertension despite optimal medical therapy, ischemic nephropathy, and cardiac destabilization syndromes who have severe renal artery stenosis are likely to benefit from renal artery revascularization...
April 2017: Current Problems in Cardiology
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