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Renal artery stenosis and ultrasound

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https://www.readbyqxmd.com/read/28690297/successful-complete-revascularization-with-pci-using-super-low-volume-of-contrast-medium-in-a-patient-with-three-vessel-disease-including-2-chronic-total-occlusions-with-severe-renal-dysfunction
#1
Masahiro Koide, Masayuki Kato, Kimihito Usui, Kayoko Mera, Yoshinori Tsubakimoto, Koji Isodono, Tomohiko Sakatani, Akiko Matsuo, Keiji Inoue, Hiroshi Fujita
The most important factor for preventing contrast-induced nephropathy (CIN) during percutaneous coronary intervention (PCI) in patients with severe renal dysfunction is to minimize the contrast volume. Herein, we report a successful case of complete revascularization after 3 separate PCI procedures using a super-low volume of contrast medium in a patient with 3-vessel disease, including two chronic total occlusions (CTOs). A 70-year-old man having exertional angina despite maximal medical therapy was referred to our hospital...
July 10, 2017: International Heart Journal
https://www.readbyqxmd.com/read/28688242/abnormal-renal-parenchyma-accumulation-of-123-i-mibg-in-a-child-with-renal-artery-stenosis
#2
Randy Yeh, Ahmed Mohammed, Aleksandr Margolin, Peter Schlossberg, Rama S Ayyala
Hypertension is rare in the pediatric population, however renal artery stenosis (RAS) is an important cause that can be difficult to diagnose. Doppler ultrasound is the first line imaging modality, with computed tomography and magnetic resonance imaging as adjunct modalities, all with variable sensitivity for RAS. The gold standard for evaluation of RAS is invasive selective catheter angiography. We present a unique multimodality case of abnormal radiotracer uptake in the renal parenchyma on 123-Iodine metaiodobenzylguanidine ((123)I MIBG) scan in a patient with unilateral RAS...
July 3, 2017: Clinical Imaging
https://www.readbyqxmd.com/read/28681070/-imaging-of-visceral-vessels
#3
REVIEW
C Stelzner, N Abolmaali, U Hecker, S Schellong
Visceral vessel processes are primarily or secondarily included in a multitude of clinical abdominal symptoms, with which the specialist in internal medicine is confronted. The spectrum ranges from more sharply outlined manifestations, such as chronic ischemic bowel disease up to dysfunctional disturbances of blood pressure regulation, such as high-grade renal artery stenosis. Sometimes diseases with prognostic implications, such as arterial aneurysms, are revealed as incidental findings. As a rule the B‑mode and duplex ultrasound can often be complemented by computed tomography (CT) and magnetic resonance imaging (MRI), as in aneurysms or portal vein thrombosis or the indications for subsequent digital subtraction angiography (DSA) and catheter-based therapy can be directly obtained from duplex and Doppler ultrasound...
July 5, 2017: Der Internist
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
#4
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/28583646/transplant-renal-artery-stenosis-evaluation-with-contrast-enhanced-ultrasound
#5
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/28441700/ultrasound-based-renal-sympathetic-denervation-for-the-treatment-of-therapy-resistant-hypertension-a-single-center-experience
#6
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/28361119/evaluation-of-carotid-ultrasonography-screening-among-kidney-transplant-candidates-a-single-center-retrospective-study
#7
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/28290908/-coronary-angioplasty-and-stenting-in-patients-older-than-80-years-immediate-and-long-term-results
#8
A M Babunashvili, D P Dundua, D S Kartashov, A A Bazarnova, A Yu Korenevich, M E Vetluzhskikh
AIM: to assess immediate and long-term results of coronary angioplasty and stenting in patients older than 80 years - a high risk group in view of the severity of concomitant pathology and extent of coronary atherosclerosis. MATERIAL AND METHODS: We conducted retrospective analysis of data from 167 patients older than 80 years (mean age 81.43+/-2.14 years) subjected to percutaneous coronary intervention from 2006 to 2013 (3.2% from total number of patients). Multivessel involvement was present in 128 patients (76...
July 2016: Kardiologiia
https://www.readbyqxmd.com/read/28268057/renal-sympathetic-denervation-system-via-intraluminal-ultrasonic-ablation-therapeutic-intravascular-ultrasound-design-and-preclinical-evaluation
#9
Gil Chernin, Iris Szwarcfiter, Yvonne Bausback, Michael Jonas
PURPOSE: To assess the safety and performance of a nonfocused and nonballooned ultrasonic (US) catheter-based renal sympathetic denervation (RDN) system in normotensive swine. MATERIALS AND METHODS: RDN with the therapeutic intravascular US catheter was evaluated in 3 experiments: (i) therapeutic intravascular US RDN vs a control group of untreated animals with follow-up of 30, 45, and 90 days (n = 6; n = 12 renal arteries for each group); (ii) therapeutic intravascular US RDN vs radiofrequency (RF) RDN in the contralateral artery in the same animal (n = 2; n = 4 renal arteries); and (iii) therapeutic intravascular US RDN in a recently stent-implanted renal artery (n = 2; n = 4 renal arteries)...
March 3, 2017: Journal of Vascular and Interventional Radiology: JVIR
https://www.readbyqxmd.com/read/28205351/functional-assessment-of-the-kidneys-in-a-10%C3%A2-month-old-child-with-renal-artery-stenosis-by-intravoxel-incoherent-motion
#10
Jochen Herrmann, Harald Ittrich, Michael Gerhard Kaul, Michael Groth, Magdalini Tozakidou, Martin Blohm, Jun Oh, Gerhard Adam
Renovascular stenosis is an important cause for arterial hypertension in childhood. We report a 10-month-old girl with arterial hypertension caused by right-sided renal artery stenosis detected by Doppler ultrasound. Magnetic resonance imaging (MRI) was performed before renal artery angioplasty to depict vascular anatomy in detail and to retrieve additional functional information of the kidneys by analysis of intravoxel incoherent motion (IVIM). The value of quantitative diffusion weighted imaging of the kidneys prior to percutaneous transluminal renal angioplasty (PTRA) is discussed...
March 2017: Nephrology
https://www.readbyqxmd.com/read/28044987/drug-eluting-stents-versus-bare-metal-stents-for-the-prevention-of-restenosis-in-patients-with-renovascular-disease
#11
Christian Bradaric, Kristin Eser, Stephanie Preuss, Michael Dommasch, Isabell Wustrow, Nicolas Langwieser, Bernhard Haller, Ilka Ott, Massimiliano Fusaro, Uwe Heemann, Karl-Ludwig Laugwitz, Adnan Kastrati, Tareq Ibrahim
AIMS: To assess the impact of drug-eluting stents (DES) compared to bare-metal stents (BMS) for the endovascular treatment of atherosclerotic renal artery stenosis (ARAS). METHODS AND RESULTS: We retrospectively evaluated all of our endovascular BMS- and DES-implantations performed in de- novo ARAS between 2000-2014 at our institution. The occurrence of in-stent restenosis (ISR) detected by ultrasound or angiography, kidney function, blood pressure (BP), and the number of antihypertensive drugs were analyzed as endpoints...
January 3, 2017: EuroIntervention
https://www.readbyqxmd.com/read/27986479/prospective-nonrandomized-study-to-evaluate-endovascular-repair-of-pararenal-and-thoracoabdominal-aortic-aneurysms-using-fenestrated-branched-endografts-based-on-supraceliac-sealing-zones
#12
Gustavo S Oderich, Mauricio Ribeiro, Jan Hofer, Jean Wigham, Stephen Cha, Julia Chini, Thanila A Macedo, Peter Gloviczki
PURPOSE: To investigate outcomes of manufactured fenestrated and branched endovascular aortic repair (F-BEVAR) endografts based on supraceliac sealing zones to treat pararenal aortic aneurysms and thoracoabdominal aortic aneurysms (TAAAs). METHODS: A total of 127 patients (91 male; mean age, 75 ± 10 years old) were enrolled in a prospective, nonrandomized single-center study using manufactured F-BEVAR (November 2013-March 2015). Stent design was based on supraceliac sealing zone in all patients with ≥ four vessels in 111 (89%)...
May 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/27966109/renal-ultrasound-and-doppler-sonography-in-hypertension-an-update
#13
Maria Boddi
Ultrasound (US) allows the non-invasive evaluation of morphological changes of kidney structure (by means of B-Mode) and patterns of renal and extrarenal vascularization (by means of color-Doppler and contrast-enhanced US). In hypertensive subjects it offers a relevant contribution to the diagnosis of early renal damage, acute or chronic nephropathies and nephrovascular disease. However, morphological changes are often detected late and non-specific and in recent years evidence has increased regarding the clinical relevance of renal resistive index (RRI) for the study of vascular and renal parenchymal renal abnormalities...
2017: Advances in Experimental Medicine and Biology
https://www.readbyqxmd.com/read/27965957/22q11-deletion-syndrome-and-urogenital-manifestations-a-clinicopathological-case-report
#14
M Vachette, G E Grant, J Bouquet de la Joliniere, M Jotterand, N Ben Ali, A Feki, R Capoccia Brugger
BACKGROUND: Deletion in the chromosomal region 22q11 results from the abnormal development of the third and fourth pharyngeal pouches during embryonic life and presents an expansive phenotype with more than 180 clinical features described that involve every organ and system. HISTORY AND SIGNS: A 23-year-old African woman presented for the first trimester echography, which revealed an isolated anechoic structure suggesting a ureteral dilatation. The suspicion of a malposition of great arteries in the second trimester indicated an amniocentesis leading to a diagnosis of 22q11 deletion...
2016: Frontiers in Medicine
https://www.readbyqxmd.com/read/27895243/contrast-less-stent-placement-for-vertebral-artery-origin-stenosis
#15
Shinzo Ota, Yoshinobu Sekihara, Takahiro Himeno, Yasue Tanaka, Tatsuya Ohtonari
We performed stent placement under intravascular ultrasound (IVUS), without the use of contrast medium, in a male patient in his 70s who had vertebral artery origin stenosis and decreased renal function. Satisfactory dilatation was achieved without complications, and the patient remained asymptomatic at 2 years of follow-up. We now report the details of this procedure. Stent placement under IVUS guidance may be useful in patients in whom contrast medium is contraindicated.
February 2017: Interventional Neuroradiology
https://www.readbyqxmd.com/read/27873231/atherosclerotic-renal-artery-stenosis
#16
Robert Schoepe, Stephen McQuillan, Debbie Valsan, Geoffrey Teehan
Atherosclerotic Renal Artery Stenosis is a form or peripheral arterial disease that tends to affect older subjects with hyperlipidemia, history of tobacco use, and who have other coexistent forms of vascular insufficiency. An abdominal bruit on physical exam can be a helpful clue. Slowly progressive, it can lead to critical narrowing of the renal arteries which creates a cascade of events such as renin-angiotensin-aldosterone activation (RAAS), hypertension, acute pulmonary edema, and renal fibrosis. The hypertension is considered a secondary form and can even be resistant to multiple antihypertensives...
2017: Advances in Experimental Medicine and Biology
https://www.readbyqxmd.com/read/27754194/br-05-2-angioplasty-of-atherosclerotic-renal-artery-stenosis-who-benefits
#17
Donghoon Choi
Atherosclerotic renal artery stenosis is an increasingly recognized medical problem especially in elderly patients. It commonly occurs with systemic manifestations including hypertension (HTN), chronic kidney disease (CKD) or atherosclerotic diseases including coronary or peripheral artery disease. Significant renal artery stenosis may result in HTN, ischemic nephropathy, however it is still in debate about the benefit of revascularization. Although several randomized controlled trials including Angioplasty and Stenting for Renal Artery Lesions (ASTRAL) and Cardiovascular Outcomes in Renal Atherosclerotic Lesions (CORAL) study has failed to reveal a significant benefit of angioplasty, angioplasty with medical therapy is increasingly accepted in some patients with certain clinical conditions...
September 2016: Journal of Hypertension
https://www.readbyqxmd.com/read/27747454/non-invasive-imaging-cannot-replace-formal-angiography-in-the-diagnosis-of-renovascular-hypertension
#18
Agnes Trautmann, Derek J Roebuck, Clare A McLaren, Eileen Brennan, Stephen D Marks, Kjell Tullus
OBJECTIVES: Renovascular disease (RVD) is found in about 10 % of secondary childhood hypertension. Digital subtraction angiography (DSA) is the gold standard to diagnose RVD. Non-invasive imaging methods like Doppler ultrasound (US), magnetic resonance angiography (MRA), and computed tomography angiography (CTA) are increasingly used. Our aim was to evaluate the role and accuracy of US, MRA, and CTA compared to DSA in diagnosing RVD in children. PATIENTS AND METHODS: A retrospective review of 127 children with suspected renovascular hypertension was performed in children referred to Great Ormond Street Hospital between 2006 and 2014 due to clinical suspicion of renovascular hypertension and/or findings on US and/or MRA or CTA...
March 2017: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
https://www.readbyqxmd.com/read/27643151/br-05-2-angioplasty-of-atherosclerotic-renal-artery-stenosis-who-benefits
#19
Donghoon Choi
UNLABELLED: Atherosclerotic renal artery stenosis is an increasingly recognized medical problem especially in elderly patients. It commonly occurs with systemic manifestations including hypertension (HTN), chronic kidney disease (CKD) or atherosclerotic diseases including coronary or peripheral artery disease. Significant renal artery stenosis may result in HTN, ischemic nephropathy, however it is still in debate about the benefit of revascularization. Although several randomized controlled trials including Angioplasty and Stenting for Renal Artery Lesions (ASTRAL) and Cardiovascular Outcomes in Renal Atherosclerotic Lesions (CORAL) study has failed to reveal a significant benefit of angioplasty, angioplasty with medical therapy is increasingly accepted in some patients with certain clinical conditions...
September 2016: Journal of Hypertension
https://www.readbyqxmd.com/read/27613386/effects-of-intravenous-bolus-injection-of-nicorandil-on-renal-artery-flow-velocity-assessed-by-color-doppler-ultrasound
#20
Yukiko Shimamoto, Takashi Kubo, Kazumi Tanabe, Hiroki Emori, Yosuke Katayama, Tsuyoshi Nishiguchi, Akira Taruya, Takeyoshi Kameyama, Makoto Orii, Takashi Yamano, Akio Kuroi, Tomoyuki Yamaguchi, Kazushi Takemoto, Yoshiki Matsuo, Yasushi Ino, Atsushi Tanaka, Takeshi Hozumi, Masaki Terada, Takashi Akasaka
BACKGROUND: Previous animal studies have shown that a potassium channel opener, nicorandil, provokes vasodilation in renal microvasculature and increases renal blood flow. We conducted a clinical study that aimed to evaluate the effect of nicorandil on renal artery blood flow in comparison with nitroglycerin by using color Doppler ultrasound. METHODS: The present study enrolled 40 patients with stable coronary artery disease who had no renal arterial stenosis and renal parenchymal disease...
January 2017: Journal of Cardiology
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