Renal artery entrapment by the diaphragmatic crus revealed by helical CT angiography.

Duré-Smith, Peter; Bloch, Robert D.; Fymat, A. L.; Chang, Pau-Yang; Hammond, P G

doi:10.2214/ajr.170.5.9574603

Cited by 15 publications

(9 citation statements)

References 6 publications

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“…8,9 The combination of RA with CA entrapment, as present in our patient, is very infrequent. 4,5,10 Treatment is generally recommended when symptoms exist that are related to the vessel constriction.…”

Section: Discussionmentioning

confidence: 48%

Laparoscopic treatment of renal artery entrapment

Bünger

Schareck

Klar

et al. 2010

Journal of Vascular Surgery

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Renal artery entrapment by the diaphragmatic crus is a very infrequent cause of renovascular hypertension. We present the case of a young man who was assigned to our hospital with arterial hypertension and stenosis of the left renal artery. Extrinsic compression was diagnosed by duplex ultrasound and magnetic resonance angiography. We performed laparoscopic decompression using the transperitoneal retrorenal approach. Antihypertensive medication could be stopped thereafter and duplex ultrasound revealed a normal blood flow to the left renal artery. We therefore propose laparoscopic treatment of left renal artery entrapment as a minimally-invasive alternative to open surgery.

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Section: Discussionmentioning

confidence: 48%

Laparoscopic treatment of renal artery entrapment

Bünger

Schareck

Klar

et al. 2010

Journal of Vascular Surgery

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“…Congenital abnormalities such as abnormal musculo-tendinous fibres [1,2,6], high ectopic RA origin [5,6] or hypertrophic diaphragmatic crus [11] were found to be responsible for these entrapments. Demonstrating whether abnormal bundles of fibres are present or not is difficult with crosssectional imaging; however, RA entrapments seem rather related to an abnormal relationship between the RA and the diaphragmatic crus, the origin of the artery being covered by the diaphragmatic crus.…”

Section: Discussionmentioning

confidence: 99%

“…Since the first report by D'Abreu [1], several cases of RAEs have been reported in the literature [2][3][4][5][6][7][8][9][10][11]. Congenital abnormalities such as abnormal musculo-tendinous fibres [1,2,6], high ectopic RA origin [5,6] or hypertrophic diaphragmatic crus [11] were found to be responsible for these entrapments.…”

Section: Discussionmentioning

confidence: 99%

“…Although Duplex ultrasound is an accurate examination for screening RA stenoses [13], it does not allow the analysis of the relationship between RA and muscular structures. CT and MRI allow for depiction of these compressions; however, reports of RAEs detected with these imaging tools are few [3,5]. This entity may also be suspected on angiographic examination or angiographic-like reconstructions with CT or MRI, when the initial course of an RA is parallel to the aorta or compressed against it.…”

Section: Discussionmentioning

confidence: 99%

“…Since this first description, fewer than 15 cases [2][3][4][5][6][7][8][9][10][11] of RA entrapment by the diaphragm and only one case with percutaneous treatment [2] have been reported in the literature. Investigation of RAs with CT or MRA allows us to have a better analysis of relationships between RAs and the diaphragm.…”

Section: Introductionmentioning

confidence: 99%

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Renal artery entrapment by the diaphragmatic crus

et al. 2005

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The aim of this study is to describe renal artery entrapment (RAE) by the diaphragmatic crus and to elucidate the diagnostic and therapeutic approach to this entity. From 1995 to 2002, 15 patients (mean age 65) were found to have a RAE. They were investigated by CT scan (n=14) and/or MRA (n=2) for hypertension (n=7), chronic renal insufficiency (n=4) or aneurysms (n=4). The right (n=11) or the left (n=4) renal artery (RA) was involved. The compression was ostial (n=8) or truncal (n=7), and was > or = 50% in eight cases. The course of the RA along the aorta on angiographic views (n=8) or a concentric ostial stenosis in a patient free of atheromatous lesions (n=7) were two findings suggestive of an RAE. Seven RAEs were indicated for treatment but only three were treated, by mean of stenting. Among the latter, two stents were patent at 6-month follow-up and one evolved to restenosis because of a stent fracture. RAEs may be suspected on angiographic views and proved by cross-sectional imaging because of specific imaging features. It is of importance to detect this etiology of RA stenosis because angioplasty with stenting is probably not always advisable.

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