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Randomized trials have failed to show clinical benefit in patients with atherosclerotic renal artery stenosis who were treated with angioplasty with or without stenting. However, these studies were done in patients with a high-grade stenosis. This paper examines whether there are arguments to consider patients with low-grade stenosis for angioplasty.
Renal artery stenosis (RAS) is a known cause of secondary hypertension and renal failure. Although renal artery angiography is the gold standard for diagnosing RAS, a simple method to estimate if patients will develop RAS is required. The aim of this retrospective study was to develop a simple risk score to predict significant RAS.
Renal artery stenosis (RAS) is a leading cause of hypertension, renal failure, pulmonary edema, and loss of renal mass. Atherothrombotic renal disease is a well-described entity, known primarily for its high mortality rate.
Carotid endarterectomy (CEA) and carotid artery stenting (CAS) are the 2 current standard treatments for carotid artery stenosis. There is still no well-defined consensus with regard to their superiority. However, the minimally invasive nature of endovascular treatment makes CAS increasingly popular among vascular surgeons.
Results from studies investigating the effect of contralateral carotid artery occlusion (CCO) in patients with carotid artery stenosis undergoing carotid artery endarterectomy (CEA) or carotid artery stenting (CAS) are variable in the literature.
Fibromuscular dysplasia is a heterogeneous group of systemic, noninflammatory, and nonatherosclerotic diseases of the vascular wall. It is the second-most common abnormality of the renal artery. Although hypertension is the most common presenting symptom, other symptoms, such as pulsatile tinnitus, stroke, chest pain, or abdominal discomfort, may result from other affected vascular beds. Revascularization of the renal artery appears to be effective at lowering blood pressure in many patients with renal arte...
Fibromuscular dysplasia (FMD), which usually affects the renal artery, also affects the carotid, vertebral, and intracranial arteries. Previous studies have shown a high prevalence of concomitant renal artery and cervicocranial lesions in FMD patients. However, the analyzed subjects were mostly Caucasians in Western countries.
Significant national variation exists in defining the degree of stenosis that requires intervention in patients with asymptomatic carotid artery stenosis (ACAS). We aimed to evaluate the risk of perioperative- and 2-year stroke and death in ACAS patients undergoing carotid endarterectomy (CEA) and carotid artery stenting (CAS) for severe versus very severe stenosis in a contemporary population.
We analyzed the results of internal carotid artery (ICA) stenosis treatment at our institution according to the treatment modality-carotid endarterectomy (CEA) vs. carotid artery stenting (CAS).
Renal artery stenosis represents a rare cause of neonatal arterial hypertension of renovascular origin, having been described few cases in the literature at this stage of life. Most patients with this disease remain asymptomatic; hypertension can be detected in routine pediatric revisions. Diagnosis can be performed by combining biochemical and radiological findings. The initial management consists of pharmacological therapy in order to achieve adequate growth. Subsequently, it is necessary to assess defini...
En bloc liver-kidney transplantation can be difficult with renal artery variations for which the risk of multiple anastomoses can outweigh the benefits.
What is central question of this study? Acute kidney injury (AKI) in patients is usually due to renal artery hypoperfusion or occasionally vein thrombosis, but murine model of ischemic AKI is mostly induced via pedicle-clamping. Hence, the traditional renal pedicle-clamping model was compared with models of occluding renal artery or vein alone in rats. What is main finding and its importance? During renal venous occlusion, transmission of high arterial pressure into renal capillaries likely caused rupture o...
The collateral circulation is important in maintenance of blood supply to the ischemic kidney distal to renal artery stenosis (RAS). Obesity-metabolic syndrome (MetS) preserves renal blood flow (RBF) in the stenotic kidney, but whether this is related to an increase of collateral vessel growth is unknown. We hypothesized that MetS increased collateral circulation around the renal artery.
Renal cell carcinoma (RCC) exhibits a natural tendency to extend from the kidney into inferior vena cava (IVC) and growing into the right atrium is a rare complication. We report a 65-year-old patient with an RCC with intravascular extension through renal vein into the IVC and right atrial combined with severe coronary artery disease. This case has not been described in the literature and there is no treatment guideline for it.
Catheter-based intravascular near-infrared spectroscopy (NIRS) detects a lipid signal from atherosclerotic plaque. The aim of this study was to describe the effect of carotid artery stenting (CAS) on the lipid signal in a carotid stenosis.
To examine the origin and development of the renal plexus and its relationship to the renal vessels in embryos and early human fetuses.
A meta-analysis found that for internal carotid artery stenosis procedures in elderly patient, the risk of perioperative stroke is significantly higher for carotid artery stenting (CAS) than for carotid endarterectomy (CEA). We retrospectively examined characteristics and perioperative results of CAS for 80 years and over at a single medical center.
Fibromuscular dysplasia (FMD) is an idiopathic, segmental, non-atherosclerotic and non-inflammatory disease of the musculature of arterial walls, leading to stenosis of small and medium-sized arteries, mostly involving renal and cervical arteries. As a result of better and more systematic screening, it appears that involvement of the splanchnic vascular bed is more frequent than originally assumed. We review epidemiology, pathogenesis, clinical picture as well as diagnosis and treatment of visceral artery (...
Resistant hypertension is defined by the inability to maintain within normal limits the blood pressure values of an individual, while he is under treatment with maximal tolerated doses of three antihypertensive agents. One of the most common types of resistant hypertension is renovascular hypertension (RVH), which is caused by the narrowing of the renal arteries, in the context of existing atherosclerotic plaques at that level. We are presenting the case of a hypertensive 56-year-old man admitted in the Cli...
True degenerative aneurysms involving the donor renal artery after kidney transplantation are rather rare. The indications for operation and optimal therapy to combat this vascular complication are still not clear. Surgical revision has been used as a potential treatment; nonetheless, it has been associated with high risk of complications. In the present study, we report on a 31-year-old woman with a true aneurysm located at transplant renal artery after transplantation that was successfully managed with st...
Recent clinical studies have recently demonstrated a strong association between carotid artery stenosis and coronary artery disease (CAD). However, the clinical impact of carotid plaque composition on CAD remains unclear. This study was aimed to determine the relationship between carotid plaque composition and CAD in patients who underwent carotid endarterectomy (CEA) or carotid artery stenting (CAS).
Carotid artery endarterectomy (CEA) remains the most common surgical intervention for the treatment of symptomatic and asymptomatic carotid artery stenosis. Several studies have shown a lower risk of periprocedural adverse events in statin-users who undergo coronary interventions orcarotid artery stenting.
Renal artery anomalies occur at a rate of 1-2% and present a challenge to vascular surgeons performing aortic surgery. We describe adjuncts used to manage such anatomic variants.
The occurrence of transplant renal artery stenosis (TRAS) ranges from 1% to 23%, and is associated with resistant hypertension, volume overload, graft dysfunction and poor long-term graft and patient survival. Enhancing graft availability with expanded criteria donors results in the transplantation of kidneys with atherosclerotic arteries, increasing the risk of vascular complications. Although endovascular management is the first line strategy in this context, in some patients surgery has to be considered....