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Renal artery stenosis and ultrasound

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https://www.readbyqxmd.com/read/27895243/contrast-less-stent-placement-for-vertebral-artery-origin-stenosis
#1
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.
November 28, 2016: Interventional Neuroradiology
https://www.readbyqxmd.com/read/27873231/atherosclerotic-renal-artery-stenosis
#2
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...
November 22, 2016: Advances in Experimental Medicine and Biology
https://www.readbyqxmd.com/read/27754194/br-05-2-angioplasty-of-atherosclerotic-renal-artery-stenosis-who-benefits
#3
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
#4
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...
October 17, 2016: 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
#5
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
#6
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...
September 6, 2016: Journal of Cardiology
https://www.readbyqxmd.com/read/27504713/comparison-of-ferumoxytol-enhanced-mra-with-conventional-angiography-for-assessment-of-severity-of-transplant-renal-artery-stenosis
#7
Ghaneh Fananapazir, Mustafa R Bashir, Michael T Corwin, Ramit Lamba, Catherine T Vu, Christoph Troppmann
PURPOSE: To determine the accuracy of ferumoxytol-enhanced magnetic resonance angiography (MRA) in assessing the severity of transplant renal artery stenosis (TRAS), using digital subtraction angiography (DSA) as the reference standard. MATERIALS AND METHODS: Our Institutional Review Board approved this retrospective, Health Insurance Portability and Accountability Act-compliant study. Thirty-three patients with documented clinical suspicion for TRAS (elevated serum creatinine, refractory hypertension, edema, and/or audible bruit) and/or concerning sonographic findings (elevated renal artery velocity and/or intraparenchymal parvus tardus waveforms) underwent a 1...
August 9, 2016: Journal of Magnetic Resonance Imaging: JMRI
https://www.readbyqxmd.com/read/27433226/renal-artery-stenosis-on-duplex-ultrasound-due-to-inferior-vena-cava-filter-leg-impingement
#8
Kathleen Hannon
We present a case study of renal artery duplex findings for new onset of hypertension in a young woman with a history of inferior vena cava filter placed a year prior and failed percutaneous retrieval. Duplex ultrasound showed significantly elevated velocities in the mid-right renal artery, consistent with renal artery stenosis. Computed tomography angiography images suggested that a leg from the inferior vena cava filter was impinging on her right renal artery, with perforation through the vena cava possibly into the wall of her duodenum...
November 2014: Ultrasound: Journal of the British Medical Ultrasound Society
https://www.readbyqxmd.com/read/27409058/retrograde-transpedal-access-for-revascularization-of-below-the-knee-arteries-in-patients-with-critical-limb-ischemia-after-an-unsuccessful-antegrade-transfemoral-approach
#9
J P Goltz, M Planert, M Horn, M Wiedner, M Kleemann, J Barkhausen, E Stahlberg
PURPOSE: To evaluate the safety and technical and clinical success of endovascular below-the-knee (BTK) artery revascularization by a retrograde transpedal access. MATERIALS AND METHODS: We retrospectively identified 16/172 patients (9.3 %) with endovascular BTK revascularization in whom a transfemoral approach had failed and transpedal access had been attempted. The dorsal pedal (n = 13) or posterior tibial (n = 3) artery was accessed using a dedicated access set and ultrasound guidance...
October 2016: RöFo: Fortschritte Auf Dem Gebiete der Röntgenstrahlen und der Nuklearmedizin
https://www.readbyqxmd.com/read/27339588/cortical-venous-infarcts-and-acute-limb-ischaemia-in-acute-carbon-monoxide-poisoning-a-rare-case-report
#10
Muhammad Farooq Hanif, Beenish Iqbal, Nooman Gilani
A case of carbon monoxide poisoning is presented with unusual complications; some of which have not been reported previously. A 48-years-old Asian male presented to the emergency department with dyspnoea, altered state of consciousness and pale discolouration of skin after being locked inside a factory room with burning coal. Patient was in acute respiratory distress. Arterial blood gas analysis showed respiratory acidosis with hypoxaemia. On 3rd day, patient developed dark coloured urine and right upper limb ischaemia...
June 2016: JPMA. the Journal of the Pakistan Medical Association
https://www.readbyqxmd.com/read/27219892/renal-artery-stenosis-are-there-patients-who-benefit-from-intervention
#11
M C Kihm, B Vogel, M Zeier, L P Kihm
Atherosclerotic renal artery stenosis (ARAS) is one of the most relevant long-term complications of atherosclerotic disease. It is associated both with hypertension and increased renal and cardiovascular risk and overall mortality. Diagnostic modalities include non-invasive duplex ultrasound, dynamic magnetic resonance angiography (MRA) and computer tomography angiography (CTA) and are confirmed by using invasive renal angiography. Percutaneous revascularization of renal artery stenosis has been studied in various clinical trials...
June 2016: Experimental and Clinical Endocrinology & Diabetes
https://www.readbyqxmd.com/read/27216744/multimodality-imaging-of-fibromuscular-dysplasia
#12
REVIEW
Sara Lewis, Daniella Kadian-Dodov, A Bansal, R A Lookstein
OBJECTIVE: Fibromuscular dysplasia (FMD) is an uncommon non-inflammatory and non-atherosclerotic cause of arterial disease that may result in stenosis, tortuosity, aneurysm, or dissection. The clinical presentation depends on the vascular bed involved and ranges from asymptomatic to multisystem disease and end organ ischemia. The purpose of this article is to review the role of imaging in patients with FMD with an emphasis on renal FMD. The relevant epidemiology, histopathology, imaging techniques, and interpretation of images will be discussed...
October 2016: Abdominal Radiology
https://www.readbyqxmd.com/read/27170344/clinical-scenarios-in-chronic-kidney-disease-vascular-chronic-diseases
#13
Mario Meola, Sara Samoni, Ilaria Petrucci
Vascular chronic diseases represent one of the leading causes of end-stage renal disease in incident dialysis patients. B-Mode ultrasound (US) and color Doppler (CD) have a high sensitivity and specificity in the diagnosis of vascular chronic diseases. US and CD should be used to identify subjects in the high risk population who are affected by main renal artery stenosis (RAS) and to identify and characterize patients without RAS who have chronic ischemic nephropathy caused by nephroangiosclerosis and/or atheroembolic disease...
2016: Contributions to Nephrology
https://www.readbyqxmd.com/read/27170301/imaging-in-chronic-kidney-disease
#14
Mario Meola, Sara Samoni, Ilaria Petrucci
Chronic kidney disease (CKD) diagnosis and staging are based on estimated or calculated glomerular filtration rate (GFR), urinalysis and kidney structure at renal imaging techniques. Ultrasound (US) has a key role in evaluating both morphological changes (by means of B-Mode) and patterns of vascularization (by means of color-Doppler and contrast-enhanced US), thus contributing to CKD diagnosis and to the follow-up of its progression. In CKD, conventional US allows measuring longitudinal diameter and cortical thickness and evaluating renal echogenicity and urinary tract status...
2016: Contributions to Nephrology
https://www.readbyqxmd.com/read/27162297/-renovascular-hypertension
#15
REVIEW
Joanna Matuszkiewicz-Rowińska, Monika Wieliczko
Renovascular hypertension (RVH) is one of the most common causes of secondary hypertension. In about 90% of cases it is due to atherosclerotic renal artery stenosis, often accompanied by severe occlusive disease in the other vessels, and as such carries a bad prognosis. In the remaining 10% patients (usually young women) the underlying vascular lesion is fibromuscular dysplasia. A presence of RVH should be suspected in patients with severe or resistant hypertension, sudden decline of renal function, sudden development or worsening of hypertension, flash pulmonary edema, impairment of renal function after treatment with renal-angiotensin-aldosterone system (RAAS) antagonists...
2015: Wiadomości Lekarskie: Organ Polskiego Towarzystwa Lekarskiego
https://www.readbyqxmd.com/read/27118604/the-use-of-intrarenal-doppler-ultrasonography-as-predictor-for-positive-outcome-after-renal-artery-revascularization
#16
Jeroen Jwm Brouwers, Rob C van Wissen, Hugo Tc Veger, Joris I Rotmans, Bart Mertens, Michel Jt Visser
Whether patients with renal artery stenosis should undergo therapeutic revascularization is controversial. In this retrospective study, we evaluated prognostic intrarenal Doppler ultrasound parameters that might have a predictive value for a beneficial response after renal revascularization. From January 2003 until December 2012, all renovascular interventions for renal artery stenosis were analyzed. The resistive index and the maximal systolic acceleration were determined by Doppler ultrasonography prior to intervention...
April 26, 2016: Vascular
https://www.readbyqxmd.com/read/27069093/duplex-ultrasound-for-identifying-renal-artery-stenosis-direct-criteria-re-evaluated
#17
Karin Zachrisson, Hans Herlitz, Lars Lönn, Mårten Falkenberg, Hampus Eklöf
BACKGROUND: Renal artery duplex ultrasound (RADUS) is an established method for diagnosis of renal artery stenosis (RAS), but there is no consensus regarding optimal RADUS criteria. PURPOSE: To define optimal cutoff values for RADUS parameters when screening for RAS using intra-arterial trans-stenotic pressure gradient measurement (PGM) as reference. MATERIAL AND METHODS: The renal arteries of 58 consecutive patients evaluated for renovascular hypertension were examined by RADUS and PGM...
April 10, 2016: Acta Radiologica
https://www.readbyqxmd.com/read/27058805/duplex-derived-intrarenal-resistance-index-correlates-with-invasive-pressure-gradient-measurements-in-detecting-relevant-unilateral-renal-artery-stenosis
#18
Elias Noory, Aljoscha Rastan, Ulrich Beschorner, Roland Macharzina, Thomas Zeller
BACKGROUND: The purpose of this study was to assess the correlation between the transstenotic pressure gradient as determined by a pressure wire and the decrease in the intrarenal resistance index (RI) > 0.05 measured by duplex ultrasound in significant unilateral renal artery stenosis (RAS). Intravascular ultrasound (IVUS) was correlated to the angiographic degree of RAS. PATIENTS AND METHODS: In 17 patients, transstenotic pressure gradient measurements, IVUS and RI measurements were obtained before and after stenting...
2016: VASA. Zeitschrift Für Gefässkrankheiten
https://www.readbyqxmd.com/read/27034579/ultrasound-diagnostics-of-renal-artery-stenosis-stenosis-criteria-ceus-and-recurrent-in-stent-stenosis
#19
W Schäberle, L Leyerer, W Schierling, K Pfister
BACKGROUND AND PURPOSE: As a non-invasive, side effect-free and cost-effective method, ultrasonography represents the method of choice for the diagnosis of renal artery stenosis. Four different criteria in total, including two direct criteria in peak systolic velocity (PSV) and renal aortic ratio (RAR) and two indirect criteria in resistance index (RI) and acceleration time (AT) for the measurement of relevant renal artery stenosis are described, each demonstrating highly variable accuracy in studies...
2016: Gefässchirurgie: Zeitschrift Für Vaskuläre und Endovaskuläre Chirurgie
https://www.readbyqxmd.com/read/26997400/takayasu-arteritis-associated-with-severe-renovascular-hypertension
#20
Mohamed Hassani
Takayasu arteritis (TA) is an inflammatory process frequently associated with stenosis and obliteration of the aorta and its primary branches. We report a 16-year-old girl in whom TA manifested mainly with a sudden decrease in visual acuity and severe arterial hypertension in both legs. Bilateral radial pulses were absent. Ultrasound showed renal size asymmetry and raised the possibility of renal artery stenosis. The diagnosis of TA was confirmed by computed tomography angiography, which showed a thickened abdominal aortic wall and narrowing of its lumen...
March 2016: Saudi Journal of Kidney Diseases and Transplantation
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