Current Opinions in Renovascular Hypertension

SummaryBackgroundRenal artery stenosis is a common cause of secondary hypertension refractory to medical therapy. Percutaneous angioplasty along with metallic stent placement has been described as an effective treatment for revascularization of the renal artery.Case ReportA 54-year-old woman affected by paranoid schizophrenia with a history of hypertension and chronic renal failure due to renal artery occlusion was treated by endovascular recanalization and stent placement that resulted in improvement of renal function and control of hypertension. Laboratory studies 4 months after the revascularization revealed blood creatinine decrease gradually from 8.57 mg/dL to 3 mg/dL.ConclusionsRevascularization with stenting has proven to be a safe and effective procedure in the treatment of total renal artery occlusion which also led to a significant relief at a psychological level.

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“…Treatment options include surgical revascularization, nephrectomy and percutaneous angioplasty with or without stenting [5]. …”

Section: Discussionmentioning

confidence: 99%

Successful Treatment of Resistant Hypertension by Means of Chronic Renal Artery Occlusion Revascularization in a Fragile Patient

et al. 2016

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“…If distinctively necessary, the current guidelines recommend stent implantation in FMD patients (class I, level of evidence B). Balloon angioplasty was highlighted by numerous published data as providing significant reduction in BP values up to normal immediately after the procedure as well as during the long-term follow-up [8,9].…”

Section: Discussionmentioning

confidence: 99%

Fibromuscular Dysplasia

2016

IJSR

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Renal artery stenosis (RAS) is associated with increased cardiovascular mortality and morbidity and may constitute a treatable cause of secondary hypertension. Fibromuscular dysplasia is frequently affecting children as the main cause of RAS, but is very rare in adults. We present the case of a 20-year-old female, with no known pathological conditions in her medical history or family background, admitted for severe headache during the past 3 days and sustained increased blood pressure (BP) (maximum BP 220/120 mmHg). The initial clinical exam and first-line imagistic methods did not provide a high suspicion for RAS. However, the invasive methods established the diagnosis of right renal artery medial dysplasia.

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“…4 There have been numerous studies assessing the imaging modalities used to evaluate renovascular hypertension from atherosclerotic disease or fibromuscular dysplasia. 5-11 This report discusses the advantages and limitations of renal artery imaging by describing a case of acute hypertension following a renal artery pseudoaneurysm caused by blunt trauma.…”

Section: Introductionmentioning

confidence: 99%

Renovascular Hypertension Associated With Pseudoaneurysm Following Blunt Trauma

Judd

Lockhart

Rizk

2013

American Journal of Kidney Diseases

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We present the case of a 21-year-old man who developed a renal artery pseudoaneurysm following a 7-foot fall onto his back. He initially presented with gross hematuria, left flank pain, and back pain. He was observed in the hospital for 3 days and discharged. One week later, he was readmitted with headache, nausea, vomiting, seizure activity, and hypertension. Contrast-enhanced computed tomography of the abdomen showed a left renal artery pseudoaneurysm with associated arterial narrowing and delayed ipsilateral renal enhancement. He underwent percutaneous stent-graft placement with resolution of the pseudoaneurysm. He was free of complications and normotensive off antihypertensive medications after 36 months of follow-up. Renal artery pseudoaneurysms are rare and under-recognized complications of blunt abdominal or back trauma that can cause hypertension. Imaging modalities in renovascular hypertension have focused on detecting renal artery stenosis from atherosclerotic disease or fibromuscular dysplasia, with little attention given to renal artery pseudoaneurysms. In addition, first-line treatment for renal artery pseudoaneurysms historically has consisted of angioembolization, yet percutaneous stent-graft placement has emerged as an attractive alternative to preserve vessel patency. We discuss the role of imaging in renovascular hypertension with a focus on renal artery pseudoaneurysms and their prevalence, diagnosis, and treatment.

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Current Opinions in Renovascular Hypertension

Cited by 17 publications

References 30 publications

Successful Treatment of Resistant Hypertension by Means of Chronic Renal Artery Occlusion Revascularization in a Fragile Patient

Successful Treatment of Resistant Hypertension by Means of Chronic Renal Artery Occlusion Revascularization in a Fragile Patient

Fibromuscular Dysplasia

Renovascular Hypertension Associated With Pseudoaneurysm Following Blunt Trauma

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