Renovascular hypertension caused by compression of the renal artery by the diaphragmatic crus

Spies, JB; LeQuire, MH; Jg, Robison; Beckett, W C; Perkinson, DT; Vicks, SL

doi:10.2214/ajr.149.6.1195

Cited by 10 publications

(5 citation statements)

References 4 publications

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“…Compression of the renal artery by the crura has been recognized as an unusual cause for renal artery stenosis and renovascular hypertension (58). An atypical high and posterior origin of the left renal artery appearing entrapped within the RCS by the diaphragmatic crus can be adequately recognized with contrast-enhanced helical CT and especially with CT angiography (59) (Fig 24).…”

Section: Vascular Disorders-mentioning

confidence: 99%

The Diaphragmatic Crura and Retrocrural Space: Normal Imaging Appearance, Variants, and Pathologic Conditions

Restrepo¹,

Eraso²,

Ocazionez³

et al. 2008

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The retrocrural space (RCS) is a small triangular region within the most inferior posterior mediastinum bordered by the two diaphragmatic crura. Multiplanar imaging modalities such as computed tomography and magnetic resonance imaging allow evaluation of the RCS as part of routine examinations of the chest, abdomen, and spine. Normal structures within the retrocrural region include the aorta, nerves, the azygos and hemiazygos veins, the cisterna chyli with the thoracic duct, fat, and lymph nodes. There is a wide range of normal variants of the diaphragmatic crura and of structures within the RCS. Diverse pathologic processes can occur within this region, including benign tumors (lipoma, neurofibroma, lymphangioma), malignant tumors (sarcoma, neuroblastoma, metastases), vascular abnormalities (aortic aneurysm, hematoma, azygos and hemiazygos continuation of the inferior vena cava), and abscesses. An understanding of the anatomy, normal variants, and pathologic conditions of the diaphragmatic crura and retrocrural structures facilitates diagnosis of disease processes within this often overlooked anatomic compartment.

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Section: Vascular Disorders-mentioning

confidence: 99%

The Diaphragmatic Crura and Retrocrural Space: Normal Imaging Appearance, Variants, and Pathologic Conditions

Restrepo¹,

Eraso²,

Ocazionez³

et al. 2008

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“…On literature review, two cases of vein patch were performed after inspection of the intima showed no irregularity. 4,8 There was one aortorenal saphenous vein bypass without MAL decompression. This was complicated by graft thrombosis, resulting in postoperative recognition of the extrinsic compression.…”

Section: Discussionmentioning

confidence: 99%

Renovascular hypertension secondary to renal artery compression by diaphragmatic crura

Mirza

Kendrick

Bower

et al. 2020

Journal of Vascular Surgery Cases, Innovations and Techniques

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Median arcuate ligament syndrome is the result of celiac axis compression by the diaphragmatic crura. Although the celiac artery is the most common vessel to have compression, the renal arteries may also rarely be compressed by the crural fibers of the diaphragm, which may cause secondary hypertension. We present two cases of renovascular hypertension secondary to renal artery compression by the diaphragmatic crura. The first patient was treated with open decompression and wide resection of the crural fibers, and the second patient was decompressed laparoscopically. Neither case required renal artery reconstruction. Antihypertensives were discontinued in both patients postoperatively.

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“…Although angioplasty and stenting of visceral arteries seems to be successful in the setting of atherosclerosis, their use in the setting of CACS has been questioned because of the presence of extrinsic compression. 17,22 The increasing applicability of stent deployment for mesenteric occlusive disease has given interventional radiologists the opportunity to expand the use of PTA and stenting to patients with CACS before primary surgical intervention. However, the few attempts of angioplasty and stenting patients with entrapment of renal arteries by diaphragmatic crura are not convincing.…”

Section: Discussionmentioning

confidence: 99%

Compression of the left renal artery and celiac trunk by diaphragmatic crura

Gaebel

Hinterseher

Saeger

et al. 2009

Journal of Vascular Surgery

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Symptomatic compression of the celiac trunk by crura of the diaphragm is a rare disorder. Even more infrequent external compression of renal arteries is found. Although the indication for surgical therapy is controversially discussed in the literature for celiac artery compression syndrome, it is unequivocally for renal artery entrapment. We present the case of a young woman who was assigned to our hospital with arterial hypertension and stenosis of the left renal artery. After percutaneous transluminal angioplasty was performed, immediate recoil occurred. Therefore, the suspicion of entrapment by diaphragmatic crura was expressed. Additionally performed diagnostic procedures including computed tomography (CT)-angiography verified our suspicion. Surgical decompression of both vessels was successfully performed.

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Renovascular hypertension caused by compression of the renal artery by the diaphragmatic crus

Cited by 10 publications

References 4 publications

The Diaphragmatic Crura and Retrocrural Space: Normal Imaging Appearance, Variants, and Pathologic Conditions

The Diaphragmatic Crura and Retrocrural Space: Normal Imaging Appearance, Variants, and Pathologic Conditions

Renovascular hypertension secondary to renal artery compression by diaphragmatic crura

Compression of the left renal artery and celiac trunk by diaphragmatic crura

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