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Sample records for atherosclerotic renal artery

  1. Atherosclerotic Renal Artery Stenosis and Hypertension: Pragmatism, Pitfalls, and Perspectives.

    Science.gov (United States)

    Bavishi, Chirag; de Leeuw, Peter W; Messerli, Franz H

    2016-06-01

    For many years and even decades, a diagnostic work-up to look for a secondary form of hypertension, particularly of renovascular origin, has been a central tenet in medicine. Atherosclerotic renal artery stenosis is considered the most common cause of renovascular hypertension. However, advances in understanding the complex pathophysiology of this condition and the recently documented futility of renal revascularization bring into question whether atherosclerotic renal artery stenosis truly causes "renovascular hypertension." From a clinical point of view, a clear distinction should be made between hypertension associated with atherosclerotic renal artery stenosis and hypertension caused by renal artery stenosis-induced activation of the renin-angiotensin-aldosterone system. Most patients with atherosclerotic renal artery stenosis do not have a form of hypertension that is remediable or improved by angioplasty; to expose them to the cost, inconvenience, and risk of a diagnostic work-up add up to little more than a wild goose chase. However, with very few exceptions, medical therapy with antihypertensives and statins remains the cornerstone for the management of patients with atherosclerotic renal artery stenosis and hypertension. PMID:26522797

  2. Improvement of renal function after opening occluded atherosclerotic renal arteries.

    Science.gov (United States)

    Kanamori, Hiroshi; Toma, Masanao; Fukatsu, Atsushi

    2009-09-01

    Percutaneous transluminal renal angioplasty (PTRA) with stenting has been effective in the control of hypertension, renal function and pulmonary edema caused by atherosclerotic renal artery stenosis (ARAS). However, concerning the viability of renal function, this procedure has not been fully established, especially in the presence of renal atrophy or severe renal parenchymal disease. We report a dramatically improved case of acute renal failure caused by acute worsening ARAS treated by stenting. A 72-year-old female was admitted for accelerated renal dysfunction (serum ceatinine; 1.2-2.3 mg/dl) and hypertension (190/100 mmHg). At 10 days after admission, the patient's serum ceatinine increased to 6.7 mg/dl, her pulmonary edema was exaggerated and hemodialysis was required. Ultrasonography showed bilateral high-echoic kidneys, but no apparent finding of renal artery stenosis (RAS). At day 15, computed tomographic angiography indicated bilateral ostial RAS. Renal angiography demonstrated total occlusion of the right and severe (90%) disease in the left. ARAS was diagnosed by intravascular ultrasonography. The guidewire was inserted in both renal arteries, PTRA with stenting was performed in the right and a stent was directly implanted in the left. Immediately, each kidney enlarged to almost normal size, leading to satisfactory urination. She was released from hemodialysis the next day since her serum creatinine was normal and the pulmonary edema was improved. Although there is still no reliable prognostic factor including resistive index or kidney size, it is important that PTRA with stenting in ARAS should be considered in a case of accelerated renal dysfunction because of the possible improvement. PMID:19726830

  3. From anatomy to function: diagnosis of atherosclerotic renal artery stenosis.

    Science.gov (United States)

    Odudu, Aghogho; Vassallo, Diana; Kalra, Philip A

    2015-12-01

    Atherosclerotic renal artery stenosis (ARAS) affects 7% of the over 65 s and will be increasingly common with an ageing population. ARAS obstructs normal renal perfusion with adverse renal and cardiovascular consequences. Drug therapy is directed at reducing atherosclerotic risk. Two recent major trials of revascularization for ARAS showed that clinical outcomes were not improved beyond those offered by optimal drug therapy in most patients. This reflects experimental data showing that restoration of blood flow alone may not attenuate a cascade of tissue injury. A shift from anatomic to functional imaging of ARAS coupled to novel therapies might improve clinical outcomes in selected patients. This review outlines the case for separately assessing hemodynamic significance of arterial stenosis and functional reserve of renal parenchymal tissue. The authors consider current and emerging diagnostic techniques for ARAS and their potential to allow individualized and functionally directed treatments. PMID:26480218

  4. Differential analysis of clinical features in atherosclerotic renal artery stenosis and benign nephrosclerosis

    Institute of Scientific and Technical Information of China (English)

    郭云珊

    2006-01-01

    Objective To analyze and compare the clinical characteristics of atherosclerotic renal artery stenosis (ARAS) and benign nephrosclerosis (BN) in order to distinguish the ARAS from BN. Methods A retrospective study was performed on 82 hypertensive patients with renal injury. Patients were divided into BN and ARAS group according to renal artery doppler scanning. The

  5. Renal dynamic imaging for the treatment assessment of renal artery angioplasty and stenting in patients with atherosclerotic renal artery stenosis

    International Nuclear Information System (INIS)

    Objective: To investigate the value of renal dynamic imaging with 99Tcm-DTPA on the evaluation and prediction of the outcome after percutaneous transluminal renal artery angioplasty and stenting (PTRAS) in patients with atherosclerotic renal artery stenosis (ARAS). Methods: Seventy-six patients with unilateral ARAS underwent PTRAS successfully. All the patients received baseline renal dynamic imaging within 2 weeks before the surgery and follow-up imaging 6 months after PTRAS. GFR (per 1.73 m2 of body surface area) of kidney with ARAS was measured with the Gates method. ARAS was classified as mild (50%-69%),moderate (70%-89%), and severe (≥90%) stenosis according to the results of renoarteriography before the surgery. GFR was graded as Ⅰ (GFR≥30 ml · min-1), Ⅱ (15 ml · min-1 ≤GFR <30 ml · min-1) and Ⅲ (GFR < 15 ml · min-1), on the baseline dynamic imaging.Blood pressure was also measured before and after the surgery. The t test, χ2 test, Fisher exact test and multiple logistic regression analysis were used for statistical analysis with SPSS 13.0. Results: The baseline GFR of kidney with mild and moderate ARAS was significant higher than that with severe stenosis ((26.79 ± 15.34) vs (19.48 ±11.56) ml · min-1, t=2.262, P=0.027). The blood pressure was improved in 32% (24/75), and not changed in 68% (51/75) of patients.Improvement of blood pressure was observed in 39.62% (21/53) of patients with a baseline GFR≥ 15 ml · min-1, and in 13.64% (3/22) of patients with a baseline GFR <15 ml · min-1 (χ2=4.825, P=0.028). Using multivariate analysis, baseline GFR ≥ 15 ml · min-1 was the only predictor of blood pressure improvement (OR=0.465, P=0.032). GFR in kidney with ARAS was improved in 22.37% (17/76), stable in 68.42% (52/76), and worse in 9.21% (7/76) of patients. The 33.33% (8/24) and 17.65% (9/51) of patients with and without blood pressure improvement, respectively, achieved GFR improvement. However, the difference was not statistically

  6. Exploration of the interventional diagnosis and treatment for atherosclerotic renal artery stenosis

    International Nuclear Information System (INIS)

    Objective: To determine the prevalence of renal artery stenosis (RAS) and the efficacy of percutaneous transluminal renal angioplasty (PTRA) and stenting in patients with documented coronary artery disease. Methods: Selective renal artery angiography or abdominal digital subtraction angiography was performed immediately after coronary angiography to detect and quantify RAS in 200 consecutive patients with known or suspected coronary artery disease. Eight severe stenotic renal arteries in 7 patients were treated with PTRA and stenting. All the lesions are considered to be atherosclerotic. Results: RAS (defined as ≥50% diameter stenosis) was detected in 21 of 200 patients (10.5%) and 19 of 99 patients with coronary artery disease (19.2 % ) who had at least one coronary artery of ≥50 % diameter stenosis. Procedure success rate was 100% in the 7 patients received PTRA and stenting. Blood pressure control improved in 74.1% patients with hypertension. Angiographic follow-up was done in 3 patients in 3 to 9 months and no restenosis was found in the vessels. Conclusions: It is necessary to routinely perform RAS for the patients with coronary artery disease undergoing coronary angiography to identify RAS, especially in those associated with hypertension, so as to diagnose and treat RAS in early stage. PTRA and stenting carries high success rate and appears to be an effective and safe treatment for RAS

  7. Association of atherosclerotic renal artery stenosis with major adverse cardiovascular events after acute myocardial infarction

    Institute of Scientific and Technical Information of China (English)

    Zheng Bin; Liu Jinghua; Ma Qin; Zhao Donghui; Wang Xin; Zheng Ze

    2014-01-01

    Background Patients with atherosclerotic renal artery stenosis (ARAS) are in substantial risk of cardiovascular adverse events.We investigated whether myocardial infarction patients with ARAS are in additional risk of cardiovascular events.Methods In this retrospective study,257 patients with type 1 myocardial infarction were enrolled.Median follow-up was 42 months.Composite endpoint events are analyzed by definitions of ARAS as ≥50% or ≥70% diameter stenosis.Results Defining ARAS as ≥70% diameter stenosis,ARAS was a significant predictor for composite endpoint events including death,non-fatal myocardial infarction,ischaemic stroke and intracranial haemorrhage,rehospitalisation for cardiac failure (HR:4.381; 95% Cl:1.770-10.842) by Cox regression analysis,but not for death.Diabetes mellitus was also a significant predictor for composite endpoint events (HR:2.756; 95% Cl:1.295-5.863).However,defining ARAS ≥50% diameter stenosis,ARAS was no longer a significant predictor for composite endpoint events or death.Conclusions Although not associated with mortality,ARAS ≥70% is associated with major adverse cardiac events after acute myocardial infarction.For prognosis,≥70% diameter stenosis is a more appropriate criteria for ARAS definition than ≥50% diameter stenosis.

  8. The prevalence and clinical predictors of incidental atherosclerotic renal artery stenosis

    Energy Technology Data Exchange (ETDEWEB)

    Ozkan, Ugur [Baskent University Faculty of Medicine, Department of Radiology, Adana/Turkey (Turkey)], E-mail: radugur@yahoo.com; Oguzkurt, Levent; Tercan, Fahri [Baskent University Faculty of Medicine, Department of Radiology, Adana/Turkey (Turkey); Nursal, Tarik Z. [Baskent University Faculty of Medicine, Department of General Surgery, Ankara/Turkey (Turkey)

    2009-03-15

    Objective: To evaluate the prevalence of incidental renal artery stenosis due to atherosclerosis and associated risk factors in patients with peripheral arterial disease (PAD). Materials and methods: To determine renal artery stenosis, aortofemoropopliteal digital substraction angiographies (DSA) of 629 consecutive patients with PAD were prospectively reviewed. Angiographies were performed as catheter angiography with automated pump injection. Of the patients, 540 were male (86%) and 89 female (14%) (mean age {+-} S.D.: 61.5 {+-} 11.1 years). Statistical analysis was performed to determine the association of significant renal artery stenosis ({>=}60% diameter stenosis) with patient demographics (age, sex, reason for angiography and smoking status), medical history (diabetes mellitus, hypertension and coronary artery disease), laboratory values (blood creatinine, fasting glucose, triglycerides, LDL, HDL and total cholesterol) and distribution of PAD (aortoiliac, femoropopliteal and crural diseases and multisegment involvement). Results: Renal artery disease was found in 33% (207 of 629) of all patients with peripheral arterial disease, and 9.6% of patients (n = 60) had significant ({>=}60%) renal artery stenosis. Only age and hypertension (blood pressure systolic >140 mmHg or diastolic >90 mmHg) were independent risk factors for significant renal artery stenosis on multivariate analysis. Mean age of patients with RAS was 66.5 {+-} 8.9 years compared with 61 {+-} 11.2 years for patients without RAS (p < 0.001). Hypertension was found in 41% of the patients in control group and in 63% of the patients in RAS group (p = 0.01). Conclusion: Incidental renal artery stenosis which can be mild or significant is a relatively common finding among patients with peripheral arterial disease. Advance age and hypertension are closely associated with significant renal artery stenosis.

  9. The prevalence and clinical predictors of incidental atherosclerotic renal artery stenosis

    International Nuclear Information System (INIS)

    Objective: To evaluate the prevalence of incidental renal artery stenosis due to atherosclerosis and associated risk factors in patients with peripheral arterial disease (PAD). Materials and methods: To determine renal artery stenosis, aortofemoropopliteal digital substraction angiographies (DSA) of 629 consecutive patients with PAD were prospectively reviewed. Angiographies were performed as catheter angiography with automated pump injection. Of the patients, 540 were male (86%) and 89 female (14%) (mean age ± S.D.: 61.5 ± 11.1 years). Statistical analysis was performed to determine the association of significant renal artery stenosis (≥60% diameter stenosis) with patient demographics (age, sex, reason for angiography and smoking status), medical history (diabetes mellitus, hypertension and coronary artery disease), laboratory values (blood creatinine, fasting glucose, triglycerides, LDL, HDL and total cholesterol) and distribution of PAD (aortoiliac, femoropopliteal and crural diseases and multisegment involvement). Results: Renal artery disease was found in 33% (207 of 629) of all patients with peripheral arterial disease, and 9.6% of patients (n = 60) had significant (≥60%) renal artery stenosis. Only age and hypertension (blood pressure systolic >140 mmHg or diastolic >90 mmHg) were independent risk factors for significant renal artery stenosis on multivariate analysis. Mean age of patients with RAS was 66.5 ± 8.9 years compared with 61 ± 11.2 years for patients without RAS (p < 0.001). Hypertension was found in 41% of the patients in control group and in 63% of the patients in RAS group (p = 0.01). Conclusion: Incidental renal artery stenosis which can be mild or significant is a relatively common finding among patients with peripheral arterial disease. Advance age and hypertension are closely associated with significant renal artery stenosis.

  10. Atherosclerotic renal artery stenosis is prevalent in cardiorenal patients but not associated with left ventricular function and myocardial fibrosis as assessed by cardiac magnetic resonance imaging

    NARCIS (Netherlands)

    Emans, Mireille E.; van der Putten, Karien; Velthuis, Birgitta K.; de Vries, Jan J. J.; Cramer, Maarten J.; America, Yves G. C. J.; Hillege, Hans L.; Meiss, Louis; Doevendans, Pieter A. F. M.; Braam, Branko; Gaillard, Carlo A. J. M.

    2012-01-01

    Background: Atherosclerotic renal artery stenosis (ARAS) is common in cardiovascular diseases and associated with hypertension, renal dysfunction and/or heart failure. There is a paucity of data about the prevalence and the role of ARAS in the pathophysiology of combined chronic heart failure (CHF)

  11. Effects of renal artery stenting on renal function and blood pressure in patients with atherosclerotic renovascular disease

    Institute of Scientific and Technical Information of China (English)

    张奇; 沈卫峰; 张瑞岩; 张建盛; 胡健; 张宪

    2003-01-01

    Objective To study the effects of percutaneous renal artery intervention on renal function and blood pressure in patients with renal artery stenosis. Methods Eighty-seven patients with severe uni- or bi-lateral renal artery stenosis (luminal diameter narrowing ≥70%) and clinical hypertension received renal artery stenting between January 2002 and December 2002. The changes in blood pressure and serum creatinine level and creatinine clearance (CCr) 48 hours after intervention and during 6 months of follow-up were assessed.Results Renal stenting was performed in 98 stenotic arteries of 87 patients, and the procedural success rate was 100%. Serum creatinine level was slightly elevated from (176±21) μmol/L to (179±11) μmol/L (P=0.15) 48 hours after the procedure, but significantly decreased to (149±15) μmol/L at 6 months (P<0.001). CCr was also greatly improved [(37±11) ml/min before versus (51±8) ml/min at 6 months, P<0.001]. During follow-up, 61% of the patients experienced a normal renal function. Despite conventional medical treatment, systolic and diastolic blood pressures were also significantly decreased after stenting [(163±23)/(96±13) mm Hg before versus (148±12)/(79±15) mm Hg at 6 months, all P<0.001], and hypertension was well controlled in 67% of the patients at 6 months ' follow-up.Conclusion Renal artery stenting has a high success rate and is effective in improving renal function and blood pressure for patients with severe renal artery stenosis.

  12. The Erasme Study: A Multicenter Study on the Safety and Technical Results of the Palmaz Stent Used for the Treatment of Atherosclerotic Ostial Renal Artery Stenosis

    International Nuclear Information System (INIS)

    Purpose: To assess, in a multicenter setting, safety, technical results, and restenosis rate of the Palmaz stent for treatment of atherosclerotic ostial renal artery stenosis. Methods: Ten centers enrolled 106 patients (120 treated renal artery stenoses) in the study. Patient selection was based on unsuccessful percutaneous transluminal renal angioplasty (residual stenosis ≥ 20%) performed for treatment of ostial stenosis ≥ 50%, in patients with hypertension and/or impaired renal function. Safety was assessed by means of the complication rate, and technical results by the number of successful stent placements and occurrence of restenosis (>50%) at intraarterial angiographic follow-up. Results: Stent placement was successful (n = 112) or partially successful (n = 5) in 117 (98%) arteries. Complications occurred in 19 procedures; seven were of serious clinical significance. Angiographic follow-up was performed in 89 of 117 (76%) cases, at a mean of 8 months (range 2.5-18 months). Fifteen stents (16.9%) showed restenosis (at a mean of 8.5 months), of which 10 were successfully redilated. Conclusion: Renal artery stenting has a high technical success rate, a complication rate comparable to percutaneous transluminal renal angioplasty, and a low rate of restenosis at 8 months angiographic follow-up

  13. Revascularisation of atherosclerotic mesenteric arteries

    DEFF Research Database (Denmark)

    Christensen, Max Greve; Lorentzen, Jørgen Ewald; Schroeder, T V

    1994-01-01

    25 patients, chronic ischaemia in 53 and prophylactic reconstruction in connection with aortic surgery in 12 patients. The superior mesenteric artery (SMA) was revascularised in 87 patients and the coeliac axis or common hepatic artery in six. Thus, only three patients had both territories......OBJECTIVES: Visceral artery surgery is well known to vascular surgeons, but most have limited personal experience. We report our experience with 90 patients treated for atherosclerotic lesions of the visceral arteries during a 25-year period 1968-1993. DESIGN: Retrospective study. SETTING...... revascularised. Thromboendarterectomy was performed in 15 patients, transposition of the SMA directly into the infrarenal aorta in 30 and bypass in 48 patients. CHIEF OUTCOME MEASURES: Cumulative symptom-free and survival rates. MAIN RESULTS: The overall perioperative (30 days) mortality rate was 13%, mainly...

  14. Renal function after renal artery stenting

    Institute of Scientific and Technical Information of China (English)

    George S. Hanzel; Mark Downes; Peter A. McCullough

    2005-01-01

    @@ Atherosclerotic renal artery stenosis (ARAS), a common clinical finding, is increasing in prevalence as the population ages. ARAS is seen in ~ 7% of persons over 65 years of age1 and in ~ 20% of patients at the time of coronary angiography.2 It is an important cause of chronic kidney disease and may result in 11-14% of cases of end stage renal disease.3

  15. Atherosclerotic renal artery stenosis is prevalent in cardiorenal patients but not associated with left ventricular function and myocardial fibrosis as assessed by cardiac magnetic resonance imaging

    Directory of Open Access Journals (Sweden)

    Emans Mireille E

    2012-09-01

    Full Text Available Abstract Background Atherosclerotic renal artery stenosis (ARAS is common in cardiovascular diseases and associated with hypertension, renal dysfunction and/or heart failure. There is a paucity of data about the prevalence and the role of ARAS in the pathophysiology of combined chronic heart failure (CHF and chronic kidney disease (CKD. We investigated the prevalence in patients with combined CHF/CKD and its association with renal function, cardiac dysfunction and the presence and extent of myocardial fibrosis. Methods The EPOCARES study (ClinTrialsNCT00356733 investigates the role of erythropoietin in anaemic patients with combined CHF/CKD. Eligible subjects underwent combined cardiac magnetic resonance imaging (cMRI, including late gadolinium enhancement, with magnetic resonance angiography of the renal arteries (MRA. Results MR study was performed in 37 patients (median age 74 years, eGFR 37.4 ± 15.6 ml/min, left ventricular ejection fraction (LVEF 43.3 ± 11.2%, of which 21 (56.8% had ARAS (defined as stenosis >50%. Of these 21 subjects, 8 (21.6% had more severe ARAS >70% and 8 (21.6% had a bilateral ARAS >50% (or previous bilateral PTA. There were no differences in age, NT-proBNP levels and medication profile between patients with ARAS versus those without. Renal function declined with the severity of ARAS (p = 0.03, although this was not significantly different between patients with ARAS versus those without. Diabetes mellitus was more prevalent in patients without ARAS (56.3% against those with ARAS (23.8% (p = 0.04. The presence and extent of late gadolinium enhancement, depicting myocardial fibrosis, did not differ (p = 0.80, nor did end diastolic volume (p = 0.60, left ventricular mass index (p = 0.11 or LVEF (p = 0.15. Neither was there a difference in the presence of an ischemic pattern of late enhancement in patients with ARAS versus those without. Conclusions ARAS is prevalent in combined CHF

  16. Management of atherosclerotic renovascular disease after Cardiovascular Outcomes in Renal Atherosclerotic Lesions (CORAL).

    Science.gov (United States)

    Herrmann, Sandra M S; Saad, Ahmed; Textor, Stephen C

    2015-03-01

    Many patients with occlusive atherosclerotic renovascular disease (ARVD) may be managed effectively with medical therapy for several years without endovascular stenting, as demonstrated by randomized, prospective trials including the Cardiovascular Outcomes in Renal Atherosclerotic Lesions (CORAL) trial, the Angioplasty and Stenting for Renal Artery Lesions (ASTRAL) trial and the Stent Placement and Blood Pressure and Lipid-Lowering for the Prevention of Progression of Renal Dysfunction Caused by Atherosclerotic Ostial Stenosis of the Renal Artery (STAR) and ASTRAL. These trials share the limitation of excluding subsets of patients with high-risk clinical presentations, including episodic pulmonary edema and rapidly progressing renal failure and hypertension. Although hemodynamically significant, ARVD can reduce renal blood flow and glomerular filtration rate; adaptive mechanisms preserve both cortical and medullary oxygenation over a wide range of vascular occlusion. Progression of ARVD to severe vascular compromise eventually produces cortical hypoxia, however, associated with active inflammatory cytokine release and cellular infiltration of the renal parenchyma. In such cases ARVD produces a loss of glomerular filtration rate that no longer is reversible simply by restoring vessel patency with technically successful renal revascularization. Each of these trials reported adverse renal functional outcomes ranging between 16 and 22% over periods of 2-5 years of follow-up. Blood pressure control and medication adjustment may become more difficult with declining renal function and may prevent the use of angiotensin receptor blocker and angiotensin-converting enzyme inhibitors. The objective of this review is to evaluate the current management of ARVD for clinical nephrologists in the context of recent randomized clinical trials and experimental research. PMID:24723543

  17. Imaging of inflamed carotid artery atherosclerotic plaques with the use of {sup 99m}Tc-HYNIC-IL-2 scintigraphy in end-stage renal disease patients

    Energy Technology Data Exchange (ETDEWEB)

    Opalinska, Marta; Pach, Dorota; Sowa-Staszczak, Anna; Glowa, Boguslaw; Hubalewska-Dydejczyk, Alicja [Jagiellonian University Medical School, Nuclear Medicine Unit, Department of Endocrinology, Cracow (Poland); Stompor, Tomasz [University of Warmia and Mazury in Olsztyn, Department of Nephrology, Hypertensiology and Internal Medicine, Faculty of Medicine, Olsztyn (Poland); Mikolajczak, Renata; Garnuszek, Piotr; Maurin, Michal; Karczmarczyk, Urszula [National Centre for Nuclear Research Radioisotope Centre POLATOM, Otwock (Poland); Fedak, Danuta [Jagiellonian University Medical School, Clinical Biochemistry, Cracow (Poland); Krzanowski, Marcin; Sulowicz, Wladyslaw [Jagiellonian University Medical School, Department of Nephrology, Cracow (Poland); Rakowski, Tomasz [Jagiellonian University Medical School, 2nd Department of Cardiology, Institute of Cardiology, Cracow (Poland)

    2012-04-15

    Identification of vulnerable plaques remains crucial for better cardiovascular risk assessment. At least 20% of inflammatory cells within unstable (vulnerable) plaques comprise T lymphocytes, which contain receptors for interleukin-2 (IL-2); those receptors can be identified by scintigraphy with radiolabelled IL-2.The aim of this study was to identify the ''inflamed'' (vulnerable) plaques by scintigraphy using IL-2 labelled with {sup 99m}Tc in the selected, high cardiovascular risk group of end-stage renal disease (ESRD) patients. A total of 28 patients (18 men, 10 women, aged 55.2 {+-} 9.6 years, 17 on peritoneal dialysis, 11 on haemodialysis) underwent common carotid artery (CCA) scintigraphy with the use of {sup 99m}Tc-hydrazinonicotinamide (HYNIC)-IL-2. In all cases, ultrasound examination of the CCA was performed and levels of selected proinflammatory factors, atherogenic markers and calcium-phosphate balance parameters were measured. Finally, the target to non-target (T/nT) ratio of IL-2 uptake in atherosclerotic plaques with intima-media thickness (IMT), classic cardiovascular risk factors and concentrations of the measured factors were compared. Increased {sup 99m}Tc-HYNIC-IL-2 uptake in atherosclerotic plaques in 38/41 (91%) cases was detected. The median T/nT ratio of focal {sup 99m}Tc-HYNIC-IL-2 uptake in atherosclerotic plaques was 2.35 (range 1.23-3.63). The mean IMT value on the side of plaques assessed by scintigraphy was 0.79 {+-} 0.18 mm (median 0.8, range 0.5-1.275). Correlations between T/nT ratio and homocysteine (R = 0.22, p = 0.037), apolipoprotein B (apoB) (R = 0.31, p = 0.008), apoB to apoA-I ratio (R = 0.29, p = 0.012) and triglyceride concentration (R = 0.26, p = 0.021) were detected. A lower T/nT ratio in patients with better parameters of nutritional status (haemoglobin, albumin, adiponectin) in comparison with patients with worse nutritional parameters (3.20 {+-} 0.5 vs 2.16 {+-} 0.68, p = 0.025) was revealed as well

  18. On Renal Artery Stenosis

    OpenAIRE

    Eklöf, Hampus

    2005-01-01

    Renal artery stenosis (RAS) is a potentially curable cause of hypertension and azotemia. Besides intra-arterial renal angiography there are several non-invasive techniques utilized to diagnose patients with suspicion of renal artery stenosis. Removing the stenosis by revascularization to restore unobstructed blood flow to the kidney is known to improve and even cure hypertension/azotemia, but is associated with a significant complication rate. To visualize renal arteries with x-ray technique...

  19. Morphology of atherosclerotic coronary arteries

    Science.gov (United States)

    Holme, Margaret N.; Schulz, Georg; Deyhle, Hans; Hieber, Simone Elke; Weitkamp, Timm; Beckmann, Felix; Herzen, Julia; Lobrinus, Johannes A.; Montecucco, Fabrizio; Mach, François; Zumbuehl, Andreas; Saxer, Till; Müller, Bert

    2012-10-01

    Atherosclerosis, the narrowing of vessel diameter and build-up of plaques in coronary arteries, leads to an increase in the shear stresses present, which can be used as a physics-based trigger for targeted drug delivery. In order to develop appropriate nanometer-size containers, one has to know the morphology of the critical stenoses with isotropic micrometer resolution. Micro computed tomography in absorption and phase contrast mode provides the necessary spatial resolution and contrast. The present communication describes the pros and cons of the conventional and synchrotron radiation-based approaches in the visualization of diseased human and murine arteries. Using registered datasets, it also demonstrates that multi-modal imaging, including established histology, is even more powerful. The tomography data were evaluated with respect to cross-section, vessel radius and maximal constriction. The average cross-section of the diseased human artery (2.31 mm2) was almost an order of magnitude larger than the murine one (0.27 mm2), whereas the minimal radius differs only by a factor of two (0.51 mm versus 0.24 mm). The maximal constriction, however, was much larger for the human specimen (85% versus 49%). We could also show that a plastic model used for recent experiments in targeted drug delivery represents a very similar morphology, which is, for example, characterized by a maximal constriction of 82%. The tomography data build a sound basis for flow simulations, which allows for conclusions on shear stress distributions in stenosed blood vessels.

  20. Angiographic assessment of renal artery pathology: how reliable

    International Nuclear Information System (INIS)

    The accuracy of the angiographic interpretation of the histologic type of renal artery stenosis was assessed using a renal pathologist's diagnosis as the gold standard. The angiograms of 42 renal artery stenoses were interpreted without other information, except age and gender, independently by six angiographers. This assessment indicated that angiography is not an accurate means by which to distinguish between the individual types of fibromuscular disease of the renal artery. However, it is a fairly accurate means by which to distinguish fibromuscular disease in general from atherosclerosis of the renal artery, 207 (82%) correct interpretations of 252. In addition, in the presence of renal artery stenosis, the absence of abdominal aortic atherosclerosis on angiography is an excellent predictor of fibromuscular renal artery disease, 17 (94%) of 18 specimens. Likewise, in the presence of a renal artery stenosis, angiographically demonstrable abdominal aortic atherosclerosis is a fair predictor of atherosclerotic renal artery disease, 16 (76%) of 21 specimens

  1. Carotid endarterectomy for atherosclerotic carotid artery stenosis

    International Nuclear Information System (INIS)

    Several randomized controlled trials (RCTs) have demonstrated carotid endarterectomy (CEA) to be more beneficial for the prevention of recurrent or first-ever ischemic stroke than treatment with antiplatelet agents in patients with moderate-severe stenosis of the cervical internal carotid artery. CEA is the standard treatment for such lesions; however, other RCTs have demonstrated carotid artery stenting (CAS) with a protective device to be comparable to CEA in patients with or without radiological or medical high-risks for CEA, although the selection criteria among these treatments have not yet been established in clinical practice. This review compares the results of RCTs valuating the superiority of CEA over medical treatment or CAS, preoperative examination, procedures of CEA, perioperative management and complications, long-term results, and indications for CEA based on the currently available evidence-based publications. A preoperative evaluation of the patients' medical condition, including atherosclerosis, is therefore important to minimize the perioperative complications of CEA, because myocardial infarction during the perioperative period is frequently observed in patients undergoing CEA. A through radiological examination such as plaque imaging is essential for selecting appropriate treatment strategies involving revascularization or medical treatment for atherosclerotic carotid artery stenosis. In addition, the surgical indications, particularly for asymptomatic lesions, should be carefully considered in light of the recent improvements in medical treatments including antihypertensive agents and statins. (author)

  2. Evidence-based medicine in renal artery stenting.

    Science.gov (United States)

    Rabbia, C; Pini, R

    2010-10-01

    Atherosclerotic renovascular disease is an increasingly recognized cause of severe hypertension and declining kidney function. Patients with atherosclerotic renovascular disease have been demonstrated to have an increased risk of adverse cardiovascular events. Over the course of the last two decades renal artery revascularization for treatment of atherosclerotic renal artery stenosis (RAS) has gained great increase via percutaneous techniques. However the efficacy of contemporary revascularization therapies in the treatment of renal artery stenosis is unproven and controversial. The indication for renal artery stenting is widely questioned due to a not yet proven benefit of renal revascularization compared to best medical therapy. Many authors question the efficacy of percutaneous renal revascularization on clinical outcome parameters, such as preservation of renal function and blood pressure control. None of the so far published randomized controlled trials could prove a beneficial outcome of RAS revascularization compared with medical management. Currently accepted indications for revascularization are significant RAS with progressive or acute deterioration of renal function and/or severe uncontrollable hypertension, renal function decline with the use of agents blocking the renin-angiotensin system and recurrent flash pulmonary edema. The key point for success is the correct selection of the patient. This article summarizes the background and the limitations of the so far published and still ongoing controlled trials. PMID:20924335

  3. "The challenge facing renal artery revascularization: what have we not proven and why we must"?

    LENUS (Irish Health Repository)

    Hynes, B G

    2012-01-04

    Endovascular renal artery stent therapy for atherosclerotic renal artery stenosis (RAS) is associated with excellent acute technical success, low complication rates and acceptable long-term patency. However, the clinical benefits to patients of renal artery stenting remain uncertain. To facilitate debate regarding the treatment of RAS, we need to understand the epidemiology, basic physiology and clinical consequences of renal artery stenosis. We must attempt to determine which patients are likely to benefit from renal artery stenting, assess the nuances of the percutaneous procedure and review the current literature pertaining to renal artery stenting.

  4. T Cell CX3CR1 Mediates Excess Atherosclerotic Inflammation in Renal Impairment.

    Science.gov (United States)

    Dong, Lei; Nordlohne, Johannes; Ge, Shuwang; Hertel, Barbara; Melk, Anette; Rong, Song; Haller, Hermann; von Vietinghoff, Sibylle

    2016-06-01

    Reduced kidney function increases the risk for atherosclerosis and cardiovascular death. Leukocytes in the arterial wall contribute to atherosclerotic plaque formation. We investigated the role of fractalkine receptor CX3CR1 in atherosclerotic inflammation in renal impairment. Apoe(-/-) (apolipoprotein E) CX3CR1(-/-) mice with renal impairment were protected from increased aortic atherosclerotic lesion size and macrophage accumulation. Deficiency of CX3CR1 in bone marrow, only, attenuated atherosclerosis in renal impairment in an independent atherosclerosis model of LDL receptor-deficient (LDLr(-/-)) mice as well. Analysis of inflammatory leukocytes in atherosclerotic mixed bone-marrow chimeric mice (50% wild-type/50% CX3CR1(-/-) bone marrow into LDLr(-/-) mice) showed that CX3CR1 cell intrinsically promoted aortic T cell accumulation much more than CD11b(+)CD11c(+) myeloid cell accumulation and increased IL-17-producing T cell counts. In vitro, fewer TH17 cells were obtained from CX3CR1(-/-) splenocytes than from wild-type splenocytes after polarization with IL-6, IL-23, and TGFβ Polarization of TH17 or TREG cells, or stimulation of splenocytes with TGFβ alone, increased T cell CX3CR1 reporter gene expression. Furthermore, TGFβ induced CX3CR1 mRNA expression in wild-type cells in a dose- and time-dependent manner. In atherosclerotic LDLr(-/-) mice, CX3CR1(+/-) T cells upregulated CX3CR1 and IL-17A production in renal impairment, whereas CX3CR1(-/-) T cells did not. Transfer of CX3CR1(+/-) but not Il17a(-/-) T cells into LDLr(-/-)CX3CR1(-/-) mice increased aortic lesion size and aortic CD11b(+)CD11c(+) myeloid cell accumulation in renal impairment. In summary, T cell CX3CR1 expression can be induced by TGFβ and is instrumental in enhanced atherosclerosis in renal impairment. PMID:26449606

  5. Donors with renal artery stenosis: Fit to donate

    OpenAIRE

    Vemuru Sunil K Reddy; Sandeep Guleria; Bora, Girdhar S.

    2012-01-01

    Kidney donation from hypertensive donors is now an accepted norm in live related kidney transplantation. The use of hypertensive donors with renal artery stenosis due to athero-sclerosis and fibromuscular dysplasia is still debated. The prime concern is about the deleterious effect of hypertension on the donor and the risk of recurrence of such lesions in the solitary kidney. Even as the response of atherosclerotic renal artery stenosis to revascularisation is unpredictable, there is an impro...

  6. Atherosclerotic lesions of supra-aortic arteries in diabetic patients

    OpenAIRE

    Vidjak, Vinko; Hebrang, Andrija; Brkljačić, Boris; Brajša, Mladen; Novačić, Karlo; Barada, Ante; Škopljanac, Andrija; Erdelez, Lidija; Crnčević, Maja; Kučan, Damir; Flegar-Meštrić, Zlata; Vrhovski-Hebrang, Danijela; Roić, Goran

    2007-01-01

    The aim of this prospective study was to determine the prevalence and localization of stenotic atherosclerotic lesions of supra-aortic arteries in diabetic patients according to age and sex. Angiograms obtained by digital subtraction angiography were analyzed in 150 diabetic patients (study group) and 150 non-diabetic patients (control group) with symptoms of cerebral ischemia. Diabetic patients were found to have a significantly higher prevalence of stenotic atherosclerotic lesions ...

  7. Management of Renal Artery Stenosis - an Update

    Directory of Open Access Journals (Sweden)

    Alhadad A

    2008-01-01

    Full Text Available The role of the renal vasculature in eliciting renovascular hypertension (RVH was established in 1934, when Goldblatt et al. [1] in a classical experimental study demonstrated that partial obstruction of the renal artery increased mean arterial blood pressure (BP. The pathophysiology of renal artery stenosis (RAS is incompletely understood but has been postulated to be related to increased afterload from neurohormonal activation and cytokine release [2].Atherosclerotic RAS (ARAS is increasingly diagnosed in the expanding elderly population, which also has a high prevalence of arterial hypertension. There is still considerable uncertainty concerning the optimal management of patients with RAS. Many hypertensive patients with RAS have co-existing essential hypertension and furthermore, it is often difficult to determine to what degree the RAS is responsible for the impairment of renal function. There are three possible treatment strategies: medical management, surgery, or percutaneous transluminal renal angioplasty (PTRA with or without stent implantation. The use of stents has improved the technical success rate of PTRA and also led to lower risk of restenosis, in particular for ostial RAS. PTRA with stenting has therefore replaced surgical revascularisation for most patients with RAS and has led to a lower threshold for intervention. The treatment of choice to control hypertension in fibromuscular dysplasia (FMD is generally accepted to be PTRA [3]. In ARAS, on the other hand, the benefits with PTRA are less clear [4] and the challenge to identify which patients are likely to benefit from revascularisation remains unknown.

  8. Duplex scan sonography of renal artery stenosis.

    Science.gov (United States)

    Rabbia, C; Valpreda, S

    2003-06-01

    Renal artery stenosis is the most common cause of potentially remediable secondary hypertension. The most common causes include atherosclerosis and fibromuscular dysplasia. Particularly the atherosclerotic form is a progressive disease that may lead to gradual and silent loss of renal functional tissue. Thus, early diagnosis of renal artery stenosis is an important clinical objective since interventional therapy may improve or cure hypertension and preserve renal function. Screening for renal artery stenosis is indicated in the suspicion of renovascular hypertension or ischemic nephropathy in order to identify patients in which an endoluminal or a surgical revascularization is advisable. In the recent years many noninvasive tests have been proposed and evaluated in the clinical practice, in alternative to arteriography. These include nuclear scan, color Doppler sonography, CT angiography and MR angiography. Sonography is usually the first diagnostic modality for the non invasive evaluation of renal vascular disease with 95% sensitivity and 90% specificity when performed in dedicated laboratories. Despite sonography is highly affected by operator dependence, and it takes a lot of time to train good operators, actually is the best screening test because it is not expensive, non invasive and accurate. When a discrepancy exists between the clinical data and the results of US, other tests are mandatory. PMID:12865875

  9. Renal function and atherosclerotic renovascular disease

    OpenAIRE

    Bax, L.

    2008-01-01

    Renovascular disease (RVD) is a potentially reversible cause of renal failure and renovascular hypertension. However, in the absence of definitive clinical trials, there is a lack of evidence regarding its optimal management. We first addressed the central role of renal function in cardiovascular disease (CVD) in part I of this thesis. Renal function seems to have a strong relationship with atherosclerosis, a generalized process which starts early in life. In patients with manifest vascular d...

  10. Drug-eluting stents in renal artery stenosis

    Energy Technology Data Exchange (ETDEWEB)

    Zaehringer, M. [Marienhospital Stuttgart, Department of Radiology, Stuttgart (Germany); Pattynama, P.M.T. [Erasmus MC-University Medical Center Rotterdam, Rotterdam (Netherlands); Talen, A. [genae associates nv, Antwerp (Belgium); Sapoval, M. [Hopital Europeen Georges Pompidou, Service de Radiologie Cardio-Vasculaire, Paris (France); Inserm U 780 epidemiologie Cardio Vasculaire, Paris (France)

    2008-04-15

    Because of higher acute and long-term success rates compared with balloon angioplasty alone, percutaneous stent implantation has become an accepted therapy for the treatment of atherosclerotic renal artery stenosis. Restenosis rates after successful renal stent placement vary from 6 up to 40%, depending on the definition of restenosis, the diameter of the treated vessel segment and comorbidities. The safety and efficacy of drug-eluting stents for the treatment of renal-artery stenosis is poorly defined. The recently published GREAT study is the only prospective study, comparing bare-metal and sirolimus-coated low profile stent systems in renal artery stenosis, showing a relative risk reduction of angiographic binary in-stent restenosis by 50%. This is an opinion paper on indications, current treatment options and restenosis rates following renal artery stenting and the potential use of drug-eluting stents for this indication. (orig.)

  11. Renal artery stent angioplasty for renovascular hypertension

    International Nuclear Information System (INIS)

    Objective: To evaluate the therapeutic results of expandable stent for treatment of atherosclerotic renovascular obstructive disease. Methods: 15 patients (10 men and 5 women, 41-75 years old; mean age, 52 years) with renal arterial hypertension underwent renal stent angioplasty including renal arterial stenosis 89%(n=13) and fully obstruction without function in 2, of which 2 patients had bilateral involvement. The stenotic range of all arterial segments showed 60% to 90% width of the normal arterial diameter. 16 stents were implanted under the guidance of fluoroscopy. The most of stents implanted were Palmaz (n=12, 75%) with regular clinical and angiographic follow up. Results: Technical success (residual stenosis <30%) was achieved in all patients without serious complication. During the follow-up (6-15 months; mean, 8 ± 4 months), hypertension was improved in 9 patients and cured in 4 patients with a total benefit of 86% and no efficacy in 2(13%). The average systolic blood pressure decreased from 27.12 ± 3.09 kPa to 18.62 ± 3.12 kPa and the average diastolic blood pressure decreased from 17.73 ± 1.92 kPa to 11.12 ± 2.43 kPa after stent treatment (P<0.05). Serum creatinine remained stable in 60% (n=9) patients with improvement in 33% (n=5) and worsened in 6% (n=1) patients. Follow-up angiography was performed in all patients with 1 case of a restenosis. 6 months after expanding through stent by using balloon, the two follow up angiographies showed a stable restenosis about 20%. Conclusions: Percutaneous transluminal stent placement is highly beneficial for patients who had renal arterial obstructive disease. The success of stent angioplasty of complete obstructive renal arteries reveals wide prospects for interventional method. (authors)

  12. Atherosclerotic Renal Artery Stenosis Prevalence and Correlations in Acute Myocardial Infarction Patients Undergoing Primary Percutaneous Coronary Interventions: Data From Nonrandomized Single‐Center Study (REN‐ACS)—A Single Center, Prospective, Observational Study

    OpenAIRE

    Burlacu, Alexandru; SIRIOPOL, Dimitrie; VORONEANU, Luminita; Nistor, Ionut; Hogas, Simona; Nicolae, Ana; Nedelciuc, Igor; TINICA, Grigore; Covic, Adrian

    2015-01-01

    Background We are the first to evaluate the prevalence of renal artery stenosis (RAS) in consecutive patients with acute myocardial infarction (AMI) referred for primary percutaneous coronary intervention from a single tertiary center. As a novelty, we assessed hydration and metabolic status and measured arterial stiffness. We elaborated a predicting model for RAS in AMI. Methods and Results One hundred and eighty‐one patients with AMI underwent concomitantly primary percutaneous coronary int...

  13. CO2 vascular anastomosis of atherosclerotic and calcified arteries

    Science.gov (United States)

    White, John V.; Leefmans, Eric; Stewart, Gwendolyn J.; Katz, Mira L.; Comerota, Anthony J.

    1990-06-01

    The technique for CO2 laser fusion vascular anastomosis in normal vessels has been well established. Normal arterial wall has a predictable thermal response to the incident laser energy, with rapid heating and cooling of collagen within the arterial wall. Since atherosclerosis involves subendothelial cellular proliferation, lipid and calcium deposition, it may modify the thermal responsiveness of the arterial wall. To this study, CO2 laser fusion anastomoses were attempted in rabbits with non-calcific atherosclerosis and humans with calcific atherosclerosis. All anastomoses were successfully completed without alteration in technique despite the presence of plaque at the site of laser fusion. Histology of rabbit vessels revealed the classic laser fusion cap within the adventitia and persistent atherosclerotic plaque at the flow surface. Duplex imaging of patients post-operatively demonstrated long term anastomotic patency in 2 of 3 fistulae. These results suggest that neither non-calcified or calcified atherosclerosis significantly alters the arterial wall thermal responsiveness to CO2 laser energy or inhibits creation of laser fusion anastomoses. Therefore, this technique may be applicable to the treatment of patients with atherosclerotic occlusive disease.

  14. Renal artery stenosis due to neurofibromatosis

    OpenAIRE

    Malav Ishwar; Kothari S

    2009-01-01

    A 4-year-old boy with hypertension due to renal artery stenosis and neurofibromatosis type 1 is presented for its rarity. Renal artery stenosis due to neurofibromatosis is underrecognized and may masquerade Takayasu′s arteritis in Asian children.

  15. The association between atherosclerotic risk factors and renal function in the general population

    NARCIS (Netherlands)

    Verhave, JC; Hillege, HL; Burgerhof, JGM; Gansevoort, RT; de Zeeuw, D; de Jong, PE

    2005-01-01

    Background. Generalized atherosclerosis is increasingly recognized as an important cause of end-stage renal disease (ESRD). We questioned to what extent atherosclerotic risk factors determine renal function in the general population. Methods. We used baseline data of the Prevention of Renal and Vasc

  16. Donors with renal artery stenosis: Fit to donate

    Directory of Open Access Journals (Sweden)

    Vemuru Sunil K Reddy

    2012-01-01

    Full Text Available Kidney donation from hypertensive donors is now an accepted norm in live related kidney transplantation. The use of hypertensive donors with renal artery stenosis due to athero-sclerosis and fibromuscular dysplasia is still debated. The prime concern is about the deleterious effect of hypertension on the donor and the risk of recurrence of such lesions in the solitary kidney. Even as the response of atherosclerotic renal artery stenosis to revascularisation is unpredictable, there is an improvement in blood pressure following revascularisation of kidneys with fibro-muscular dysplasia. The first use of such kidney donors was reported in 1984 and, since then, there have been a few reports of successful use of kidneys from donors with renal artery stenosis. We report here two interesting cases of successful transplantation of kidneys from live related kidney donors with hypertension due to renal artery stenosis who became normotensive with good graft function in the recipient. We conclude that moderately hypertensive donors with renal artery stenosis are fit to donate.

  17. Lipid and protein maps defining arterial layers in atherosclerotic aorta

    Directory of Open Access Journals (Sweden)

    Marta Martin-Lorenzo

    2015-09-01

    Full Text Available Subclinical atherosclerosis cannot be predicted and novel therapeutic targets are needed. The molecular anatomy of healthy and atherosclerotic tissue is pursued to identify ongoing molecular changes in atherosclerosis development. Mass Spectrometry Imaging (MSI accounts with the unique advantage of analyzing proteins and metabolites (lipids while preserving their original localization; thus two dimensional maps can be obtained. Main molecular alterations were investigated in a rabbit model in response to early development of atherosclerosis. Aortic arterial layers (intima and media and calcified regions were investigated in detail by MALDI-MSI and proteins and lipids specifically defining those areas of interest were identified. These data further complement main findings previously published in J Proteomics (M. Martin-Lorenzo et al., J. Proteomics. (In press; M. Martin-Lorenzo et al., J. Proteomics 108 (2014 465–468. [1,2].

  18. Lipid and protein maps defining arterial layers in atherosclerotic aorta.

    Science.gov (United States)

    Martin-Lorenzo, Marta; Balluff, Benjamin; Maroto, Aroa S; Carreira, Ricardo J; van Zeijl, Rene J M; Gonzalez-Calero, Laura; de la Cuesta, Fernando; Barderas, Maria G; Lopez-Almodovar, Luis F; Padial, Luis R; McDonnell, Liam A; Vivanco, Fernando; Alvarez-Llamas, Gloria

    2015-09-01

    Subclinical atherosclerosis cannot be predicted and novel therapeutic targets are needed. The molecular anatomy of healthy and atherosclerotic tissue is pursued to identify ongoing molecular changes in atherosclerosis development. Mass Spectrometry Imaging (MSI) accounts with the unique advantage of analyzing proteins and metabolites (lipids) while preserving their original localization; thus two dimensional maps can be obtained. Main molecular alterations were investigated in a rabbit model in response to early development of atherosclerosis. Aortic arterial layers (intima and media) and calcified regions were investigated in detail by MALDI-MSI and proteins and lipids specifically defining those areas of interest were identified. These data further complement main findings previously published in J Proteomics (M. Martin-Lorenzo et al., J. Proteomics. (In press); M. Martin-Lorenzo et al., J. Proteomics 108 (2014) 465-468.) [1,2]. PMID:26217810

  19. Renal artery stenosis in patients with established coronary artery disease: Prevalence and predicting factors

    Directory of Open Access Journals (Sweden)

    Mohammad Reza Khatami

    2014-01-01

    Full Text Available The association between renal artery stenosis (RAS and other atherosclerotic diseases (particularly coronary artery diseases is well known. In general, the risk factors for atherosclerosis have been clarified, but whether these risk factors operate equally in all forms of atherosclerotic diseases is not known. The aim of this study was to describe the prevalence of RAS in patients with established coronary artery diseases and then to define the most important risk factors that may help to predict the RAS in this population. In this cross-sectional study, 146 patients with established coronary artery stenosis by angiography simultaneously underwent renal angiography; RAS >50% was considered significant. We found that 25.3% of patients with coronary artery diseases had RAS. The prevalence of significant stenosis was 17.1%. Females were more vulnerable to this disorder than males (47.1% vs. 13.7%, P = 0.001. There was no relationship between the severity and number of stenosed coronary arteries and those of stenosed renal arteries (P = 0.716. Multi-variate logistic regression analysis revealed that among the risk factors for atherosclerosis, female sex (P = 0.001, duration of hypertension (P = 0.032, age (P = 0.046 and serum creatinine (P = 0.018 were strong predictors of the presence of RAS. We concluded that RAS is a common finding in patients with coronary artery disease. We suggest that all older females with deteriorating renal function and long-standing hypertension should be carefully evaluated for early detection of the RAS.

  20. Atherosclerotic Aneurysm of the Basilar Artery and Hydrocephalus. A Case Report

    Directory of Open Access Journals (Sweden)

    Ania Alvarado Borges

    2014-08-01

    Full Text Available Intracranial aneurysms are fairly common. Many of them produce no symptoms, often remaining undiagnosed during life. At autopsy, aneurysms of the basilar artery appear in 2 to 5% of the cases; among them, saccular and congenital aneurysms are more common than atherosclerotic and fusiform aneurysms. A case of atherosclerotic aneurysm of the basilar artery diagnosed at autopsy in an 88-year-old man is presented. This patient had been admitted with a diagnosis of ischemic stroke, intracranial hypertension and hydrocephalus, which led physicians to consider a posterior fossa tumor. This paper aims at presenting the autopsy findings that showed the presence of an atherosclerotic aneurysm of the basilar artery.

  1. Hypertensive encephalopathy complicating transplant renal artery stenosis.

    OpenAIRE

    McGonigle, R J; Bewick, M.; Trafford, J. A.; Parsons, V

    1984-01-01

    A 26-year-old female diabetic patient developed hypertensive encephalopathy with gross neurological abnormalities complicating renal artery stenosis of her transplant kidney. The elevated blood pressure was unresponsive to medical treatment. Surgical correction of the stenoses in the renal artery cured the hypertension and renal failure and led to the patient's complete recovery.

  2. Renal sympathetic denervation: MDCT evaluation of the renal arteries.

    LENUS (Irish Health Repository)

    Hutchinson, Barry D

    2013-08-01

    Percutaneous transluminal renal sympathetic denervation is a new treatment of refractory systemic hypertension. The purpose of this study was to assess the clinical utility of MDCT to evaluate the anatomic configuration of the renal arteries in the context of renal sympathetic denervation.

  3. Evaluation of renal artery stenosis using color Doppler sonography in young patients with multiple renal arteries

    Institute of Scientific and Technical Information of China (English)

    QIN Wei; ZHANG Xin; YANG Min; ZHONG Xu-hui; ZHAO Ming-hui

    2011-01-01

    Background Some individuals have multiple renal arteries. Severe stenosis in one of the arteries may cause refractory hypertension. The detection of stenosis within one of the multiple renal arteries usually required invasive procedures, such as computed tomographic angiography (CTA) and magnetic resonance angiography (MRA). This study reported the application of color Doppler sonography (CDS) in the detection of severe stenosis in one of the multiple arteries.Methods Patients with multiple renal arteries and one of the arteries with severe stenosis were retrospectively studied. Peak systolic velocities (PSV) of renal arteries and the intrarenal CDS patterns were collected and compared. The diagnosis was confirmed by digital subtraction angiography (DSA).Results Four children with multiple renal arteries and one of the arteries with stenosis were investigated. They were admitted due to refractory hypertension. CDS screening identified two renal arteries in one kidney of each patient with one of the two renal arteries having stenosis >70%. The PSV of the stenosed arteries were much higher, and the intrarenal CDS patterns supplied by the stenosed arteries changed into T-P patterns.Conclusion Non-invasive CDS technology may be a useful method to identify severe stenosis in one of multiple renal arteries in young patients.

  4. Repair of an Atherosclerotic Coronary Artery Aneurysm by Implantation of a Coronary Covered Stent

    Directory of Open Access Journals (Sweden)

    Antenor Portela

    2002-05-01

    Full Text Available An atherosclerotic aneurysm of the right coronary artery complicated by a recent myocardial infarction was successfully treated with coronary artery stenting, using a device consisting of 2 stents with a layer of expandable polytetrafluorethylene (PTFE placed between them. A follow-up angiograph 5 months after the procedure showed sustained initial results.

  5. [Current management of renal artery stenosis].

    Science.gov (United States)

    Lenz, T

    2013-12-01

    Severe renal artery stenosis may cause renovascular hypertension; in case of bilateral narrowing or in a stenotic solitary kidney, renal insufficiency (ischemic kidney disease) or rarely pulmonary flush edema may occur. Renal artery stenosis may be treated by revascularization, using either percutaneous (balloon angioplasty, stenting) or less common open surgical procedures, both with excellent primary patency rates. However, randomized trials of renal artery angioplasty or stenting have failed to demonstrate a longer-term benefit with regard to blood pressure control and renal function over medical management alone (except for fibromuscular disease). Furthermore, endovascular procedures are associated with substantial risks. It has not yet been demonstrated that renal revascularization leads to a prolongation of event-free survival. Careful patient selection is essential to maximize the potential benefit. PMID:24217529

  6. Assessment of normal and atherosclerotic arterial wall thickness with an intravascular ultrasound imaging catheter.

    OpenAIRE

    Mallery, JA; Tobis, JM; Griffith, J.; Gessert, J; McRae, M; Moussabeck, O; Bessen, M; Moriuchi, M; Henry, WL

    1990-01-01

    A prototype intravascular ultrasound imaging catheter with a 20 MHz transducer was used to obtain 59 cross-sectional images in 14 segments of human atherosclerotic arteries. Three distinct components of the arterial wall were visualized on the ultrasound images: a highly reflective intima, an echolucent media, and a moderately reflective adventitia. Images were obtained at 1 mm increments in vitro and were compared with histologic sections at the same levels. Measurements of the arterial laye...

  7. Quantification of [18F]-FDG uptake in atherosclerotic plaque. Impact of renal function

    International Nuclear Information System (INIS)

    Impaired renal function causes both increased and prolonged tracer availability in the blood-pool which might result in increased tracer accumulation in atherosclerotic lesions. Therefore, the aim of this study was to investigate a possible correlation between the intensity of tracer uptake in atherosclerotic lesions and renal function. Data from 50 [18F]-fluoro-2-deoxy-D-glucose (FDG) scans were visually evaluated for tracer uptake in vessel wall alterations. Lesions were analyzed semiquantitatively by determining the blood-pool standardized uptake values (SUVblood-pools), maximum SUVs (SUVmaxs), and the target-to-background ratio (TBR). These parameters were tested for correlation with estimated glomerular filtration rate (eGFR), and cardiovascular risk factors. Both SUVblood-pools (rs=-0.32, p=0.03) and SUVmaxs for [18F]-FDG (rs=-0.50, p18F]-FDG demonstrated a significant positive correlation with eGFRs (rs=0.21, p=0.02). This study found that both intravascular tracer availability (SUVblood-pool) and intralesional tracer uptake (SUVmax) are influenced by renal function. Calculation of TBR to account for that effect may result in overcorrection in case of [18F]-FDG. Renal insufficiency or subclinical changes in renal function have to be considered as a confounding factor in PET of atherosclerotic lesions. (author)

  8. In vivo determination of arterial collagen synthesis in atherosclerotic rabbits

    International Nuclear Information System (INIS)

    Collagen and non-collagen protein synthesis rates were determined in vivo in tissues from rabbits fed a control or atherogenic diet supplemented with 2% peanut oil and 0.25% cholesterol for 4 months. Rabbits received a bolus intravenous injection of L-[3H]-proline (1.0 mCi/kg) and unlabeled L-proline (7 mmoles/kg) in 0.9% NaCl. Plasma proline specific activity decreased only 20% over 5 hr and was similar to the specific activity of free proline in tissues. Thoracic aortas from atherosclerotic rabbits exhibited raised plaques covering at least 75% of the surface. Thoracic intima plus a portion of the media (TIM) was separated from the remaining media plus adventitia (TMA). Dry delipidated weight, total collagen content, and collagen as a percent of dry weight were increased significantly in the TIM of atherosclerotic rabbits. Collagen synthesis rates and collagen synthesis as a percent of total protein synthesis were likewise increased both in the TIM and in the abdominal aortas. No differences from controls either in collagen content or collagen synthesis rates were observed in the TMA, lung or skin. These results demonstrate for the first time in vivo that formation of atherosclerotic plaques is associated with increased rates of collagen synthesis. Furthermore, as previously observed with incubations in vitro, collagen synthesis was elevated to a greater extent than noncollagen protein synthesis in atherosclerotic aortas from rabbits fed cholesterol plus peanut oil

  9. Arterial embolization in patients with renal carcinoma

    DEFF Research Database (Denmark)

    Christensen, S W; Berg, J; Brynitz, S;

    1989-01-01

    The literature concerning embolization of the renal artery in patients with renal cell carcinoma is reviewed. Based on this review it is concluded that the method is useful in this patient group as it will facilitate the surgical procedure if nephrectomy is performed afterwards. Used as a...

  10. When stenting in renal artery stenosis? Update on pathophysiology of ischemic nephropathy and management strategies

    Directory of Open Access Journals (Sweden)

    Alessandro Zuccalà

    2013-11-01

    Full Text Available In recent years, decisions taken on the optimal management of patients with renal artery stenosis have triggered off controversy and debate among clinicians dealing with renovascular disease. The main reason underlying this ongoing controversy may be the heterogeneity of the clinical entities that are normally associated with the umbrella definition of renal artery stenosis. Indeed a causal link between the stenosis and its clinical consequences (i.e. hypertension, renal failure can often demonstrated in some entities, such as fibromuscular dysplasia, truncal stenosis or arterial stenosis in the transplanted kidney, which can be defined as pure renal artery stenosis. On the contrary, the entity generally called ostial stenosis is a disease of the abdominal aorta where it encroaches the ostium of the renal artery at the end of a long process involving the entire vascular tree. Patients affected by ostial stenosis also suffer from generalized atherosclerosis, and kidney damage is often caused by the atherosclerotic environment with the stenosis acting as an innocent bystander. This may account for the low rate of renal function recovery in subjects with ostial stenosis. In our view, keeping the different entities separate along with a careful understanding of the mechanisms underpinning renal damage, particularly the intrarenal activation of the renin angiotensin system which in turn induces renal inflammation and oxidative stress, may enable clinicians to make the right decisions in regard to revascularization.

  11. Symptomatic intracranial vertebral artery atherosclerotic stenosis (≥70%) with concurrent contralateral vertebral atherosclerotic diseases in 88 patients treated with the intracranial stenting

    Energy Technology Data Exchange (ETDEWEB)

    Wang, Zi-Liang [Stroke Center, Henan Provincial People’s Hospital, Zhengzhou University (China); Gao, Bu-Lang [Department of Medical Research Shijiazhuang First Hospital, Hebei Medical University (China); Li, Tian-Xiao, E-mail: litianxiaod@163.com [Stroke Center, Henan Provincial People’s Hospital, Zhengzhou University (China); Cai, Dong-Yang; Zhu, Liang-Fu; Bai, Wei-Xing; Xue, Jiang-Yu; Li, Zhao-Shuo [Stroke Center, Henan Provincial People’s Hospital, Zhengzhou University (China)

    2015-09-15

    Highlights: • Symptomatic vertebral artery stenosis can be treated with intracranial stenting. • Stenting for intracranial vertebral artery stenosis is safe and effective. • Stenting for intracranial vertebral artery stenosis can prevent long-term stroke. - Abstract: Purpose: To investigate the safety, effect and instent restenosis rate of Wingspan stenting in treating patients with intracranial vertebral artery atherosclerotic stenosis (70–99%) concurrent with contralateral vertebral artery atherosclerotic diseases. Materials and methods: Eighty-eight patients with severe symptomatic intracranial vertebral artery atherosclerotic stenosis (≥70%) combined with contralateral vertebral artery atherosclerotic diseases were treated with the Wingpsan stent. All the baseline, cerebral angiography, success rate, perioperative complications, clinical and imaging follow-up data were prospectively analyzed. Results: The success rate of stenting was 100%, and the mean stenotic rate was reduced from prestenting (84.9 ± 6.8)% to poststenting (17.2 ± 5.9)%. The perioperative stroke rate was 1.1%. Among eighty patients (90.9%) with clinical follow-up 8-62 months (mean 29.3 ± 17.2) poststenting, five (6.3%) had posterior circulation TIA only, three (3.8%) had mild stroke in the posterior circulation but recovered completely, and another five patients greater than 70 years old died of non-ischemic stroke. Imaging follow-up in 46 patients (52.3%) 5–54 months (mean 9.9 ± 9.9) following stenting revealed instent restenosis in 12 patients (26.1%) including 7 (58.3%) symptomatic restenosis. Age and residual stenosis were the two factors to significantly (P < 0.05) affect instent restenosis. Conclusion: Wingspan stenting in the intracranial vertebral artery atherosclerotic stenosis combined with contralateral vertebral artery atherosclerotic diseases has a low perioperative stroke rate and a good preventive effect on long-term ischemic stroke, but the instent restenosis

  12. Symptomatic intracranial vertebral artery atherosclerotic stenosis (≥70%) with concurrent contralateral vertebral atherosclerotic diseases in 88 patients treated with the intracranial stenting

    International Nuclear Information System (INIS)

    Highlights: • Symptomatic vertebral artery stenosis can be treated with intracranial stenting. • Stenting for intracranial vertebral artery stenosis is safe and effective. • Stenting for intracranial vertebral artery stenosis can prevent long-term stroke. - Abstract: Purpose: To investigate the safety, effect and instent restenosis rate of Wingspan stenting in treating patients with intracranial vertebral artery atherosclerotic stenosis (70–99%) concurrent with contralateral vertebral artery atherosclerotic diseases. Materials and methods: Eighty-eight patients with severe symptomatic intracranial vertebral artery atherosclerotic stenosis (≥70%) combined with contralateral vertebral artery atherosclerotic diseases were treated with the Wingpsan stent. All the baseline, cerebral angiography, success rate, perioperative complications, clinical and imaging follow-up data were prospectively analyzed. Results: The success rate of stenting was 100%, and the mean stenotic rate was reduced from prestenting (84.9 ± 6.8)% to poststenting (17.2 ± 5.9)%. The perioperative stroke rate was 1.1%. Among eighty patients (90.9%) with clinical follow-up 8-62 months (mean 29.3 ± 17.2) poststenting, five (6.3%) had posterior circulation TIA only, three (3.8%) had mild stroke in the posterior circulation but recovered completely, and another five patients greater than 70 years old died of non-ischemic stroke. Imaging follow-up in 46 patients (52.3%) 5–54 months (mean 9.9 ± 9.9) following stenting revealed instent restenosis in 12 patients (26.1%) including 7 (58.3%) symptomatic restenosis. Age and residual stenosis were the two factors to significantly (P < 0.05) affect instent restenosis. Conclusion: Wingspan stenting in the intracranial vertebral artery atherosclerotic stenosis combined with contralateral vertebral artery atherosclerotic diseases has a low perioperative stroke rate and a good preventive effect on long-term ischemic stroke, but the instent restenosis

  13. Calculation of arterial wall temperature in atherosclerotic arteries: effect of pulsatile flow, arterial geometry, and plaque structure

    Directory of Open Access Journals (Sweden)

    Kim Taehong

    2007-03-01

    Full Text Available Abstract Background This paper presents calculations of the temperature distribution in an atherosclerotic plaque experiencing an inflammatory process; it analyzes the presence of hot spots in the plaque region and their relationship to blood flow, arterial geometry, and inflammatory cell distribution. Determination of the plaque temperature has become an important topic because plaques showing a temperature inhomogeneity have a higher likelihood of rupture. As a result, monitoring plaque temperature and knowing the factors affecting it can help in the prevention of sudden rupture. Methods The transient temperature profile in inflamed atherosclerotic plaques is calculated by solving an energy equation and the Navier-Stokes equations in 2D idealized arterial models of a bending artery and an arterial bifurcation. For obtaining the numerical solution, the commercial package COMSOL 3.2 was used. The calculations correspond to a parametric study where arterial type and size, as well as plaque geometry and composition, are varied. These calculations are used to analyze the contribution of different factors affecting arterial wall temperature measurements. The main factors considered are the metabolic heat production of inflammatory cells, atherosclerotic plaque length lp, inflammatory cell layer length lmp, and inflammatory cell layer thickness dmp. Results The calculations indicate that the best location to perform the temperature measurement is at the back region of the plaque (0.5 ≤ l/lp ≤ 0.7. The location of the maximum temperature, or hot spot, at the plaque surface can move during the cardiac cycle depending on the arterial geometry and is a direct result of the blood flow pattern. For the bending artery, the hot spot moves 0.6 millimeters along the longitudinal direction; for the arterial bifurcation, the hot spot is concentrated at a single location due to the flow recirculation observed at both ends of the plaque. Focusing on the

  14. In vivo transfer of lipoprotein(a) into human atherosclerotic carotid arterial intima

    DEFF Research Database (Denmark)

    Nielsen, Lars Bo; Grønholdt, Marie-Louise; Schroeder, T V; Stender, S; Nordestgaard, B G

    1997-01-01

    The aim of this study was to compare the atherogenic potential of lipoprotein(a) [Lp(a)] and LDL by measuring the intimal clearance of these two plasma lipoproteins in the atherosclerotic intima of the human carotid artery in vivo. Autologous 131I-Lp(a) and 125I-LDL were mixed and reinjected intr...

  15. Acute transplant renal artery thrombosis due to distal renal artery stenosis: A case report and review of the literature

    OpenAIRE

    Fallahzadeh, Mohammad Kazem; Yatavelli, Rajini Kanth; Kumar, Ajay; Singh, Neeraj

    2014-01-01

    Background: Acute renal artery thrombosis is a devastating complication of renal transplantation that can result in graft loss if not detected early. Surgical and technical errors are the major cause of renal artery thrombosis. In this article, for the first time, we are reporting a case of acute renal artery thrombosis that developed early post-transplantation due to distal renal artery stenosis. Case Presentation: A 71-year-old woman presented with nausea, vomiting and decreased urine outpu...

  16. Spontaneous renal artery dissection: current perspective

    International Nuclear Information System (INIS)

    Spontaneous Renal artery dissection is a rare entity that may remain clinically silent or present with non-specific signs and symptoms, which makes it a diagnostic challenge. It may be associated with certain underlying vascular pathologies, but its occurrence remains idiopathic in the majority of cases. While there are no evidence-based guidelines for its management, blood pressure control and preservation of renal function remain the cardinal goals of therapy. (author)

  17. The new technique of using the epigastric arteries in renal transplantation with multiple renal arteries

    Directory of Open Access Journals (Sweden)

    Mohammad Ali Amirzargar

    2013-01-01

    Full Text Available The most common anatomic variant seen in the donor kidneys for renal transplantation is multiple renal arteries (MRA, which can cause an increased risk of complications. We describe the long-term outcomes of 16 years of experience in 76 kidney transplantations with MRAs. In a new reconstruction technique, we remove arterial clamps after anastomosing the donor to the recipient′s main renal vessels, which cause backflow from accessory arteries to prevent thrombosis. By this technique, we reduce the ischemic times as well as the operating times. Both in live or cadaver donor kidneys, lower polar arteries were anastomosed to the inferior epigastric artery and upper polar arteries were anastomosed to the superior epigastric arteries. Injection of Papaverine and ablation of sympathic nerves of these arteries dilate and prevent them from post-operative spasm. Follow-up DTPA renal scan in all patients showed good perfusion and function of the transplanted kidney, except two cases of polar arterial thrombosis. Mean creatinine levels during at least two years of follow-up remained acceptable. Patient and graft survival were excellent. No cases of ATN, hypertension, rejection and urologic complications were found. In conclusion, this technique can be safely and successfully utilized for renal transplantation with kidneys having MRAs, and may be associated with a lower complication rate and better graft function compared with the existing techniques.

  18. Association of Atherosclerotic Peripheral Arterial Disease with Adiponectin Genes SNP+45 and SNP+276: A Case-Control Study

    OpenAIRE

    Sorana D. Bolboacă; Doru Pamfil; Gherman, Claudia D.

    2013-01-01

    Objectives. We hypothesized that adiponectin gene SNP+45 (rs2241766) and SNP+276 (rs1501299) would be associated with atherosclerotic peripheral arterial disease (PAD). Furthermore, the association between circulating adiponectin levels, fetuin-A, and tumoral necrosis factor-alpha (TNF-α) in patients with atherosclerotic peripheral arterial disease was investigated. Method. Several blood parameters (such as adiponectin, fetuin-A, and TNF-α) were measured in 346 patients, 226 with atherosclero...

  19. Autofluorescence maps of atherosclerotic human arteries - A new technique in medical imaging

    International Nuclear Information System (INIS)

    A new medical imaging technique for arterial walls based on laser-induced autofluorescence spectroscopy is reported. The internal surface of isolated arteries with or without atherosclerosis is irradiated with an argon ion laser (458 nm) and the peak intensity of the excited autofluorescence spectrum is related to the composition of the arterial wall. The higher autofluorescence intensity in the range between approximately 480 and 630 nm for grossly calcified tissue compared to normal or noncalcified atherosclerotic tissue is used to produce maps of the arterial wall. These images delineate the calcified areas of the sample with good spatial resolution. If this technique can be adapted to the endoscopic visualization of arteries in vivo (angioscopy), it could become an important tool for the diagnosis of atherosclerosis and for the monitoring of atheroma ablation during laser angioplasty

  20. Renal artery embolization in severe nephrotic syndrome.

    Science.gov (United States)

    Solak, Yalcin; Koc, Osman; Ucar, Ramazan; Ozbek, Orhan; Ergenc, Hasan; Gaipov, Abduzhappar; Turk, Suleyman

    2016-07-01

    Introduction Severe nephrotic syndrome is associated with increased morbidity and mortality. Renal artery embolization (RAE) has been used in a number of renal diseases such as renal tumors, arteriovenous fistulas etc. However, data regarding benefits of RAE in patients with symptomatic severe proteinuria is limited. We decided to evaluate role of RAE in the setting of severe symptomatic nephrotic syndrome. Methods Eight patients who had undergone transcatheter renal artery embolization with polyvinyl alcohol (PVA) were included. Clinico-demographic characteristics as well as baseline laboratory data including level of proteinuria, serum albumin, C-reactive protein and LDL cholesterol levels were recorded for each patient. After RAE, outpatient clinic control laboratory values were also assessed. Findings All patients except one underwent bilateral RAE (four simultaneous or three sequential). Two patients experienced postembolization syndrome characterized by flank pain, fever, and leukocytosis, which was self-limited and responded to analgesics in all patients. There was no technical complications associated with RAE procedure. All patients became anuric except one. Serum albumin levels increased and serum LDL-cholesterol levels decreased considerably in treated patients. Discussion Renal artery embolization with the purpose of amelioration in nephrotic syndrome complications was effective and free of major technical complications in our patients. PMID:26833695

  1. High origin of left testicular artery associated with accessory renal artery and renal cyst; a cadaveric observation

    Directory of Open Access Journals (Sweden)

    Lakshmi Kantha B.M.

    2013-06-01

    Full Text Available The variation in origin of the testicular artery is not uncommon, few reports about a high origin from the abdominal aorta exist in the literature. The renal artery is known to exhibit variations in its number and position. The knowledge of this variation will help the radiologists and surgeons in avoiding clinical complication during interventions. During routine dissection teaching to first year MBBS students at Sapthagiri Medical College, Bangalore we found variation in vascular pattern of testicular and renal artery associated with renal cyst. Photographs of the variations were taken. There was high origin of left testicular artery and accessory left renal artery associated with bilateral simple renal cyst in adult Male cadaver aged around 60years.There was also prehilar division of right renal artery associated with renal cyst. Anomalies in the origin, course and number of testicular artery were observed in 4.7 percent of cases. Additional renal vessels are known as the accessory renal artery and their incidence varies between 9-76%. In the present case there was high origin of left testicular artery associated with accessory renal artery and renal cyst. This anatomical knowledge of the presence of accessory renal artery and high origin of testicular artery in this case is important for radiologists, surgeons and urologist in their clinical practice. [Int J Res Med Sci 2013; 1(3.000: 308-312

  2. Factors Influencing the Disturbed Flow Patterns Downstream of Curved Atherosclerotic Arteries

    Institute of Scientific and Technical Information of China (English)

    Biyue Liu

    2008-01-01

    Pulsatile blood flows in curved atherosclerotic arteries are studied by com-puter simulations. Computations are carried out with various values of physiological parameters to examine the effects of flow parameters on the disturbed flow patterns downstream of a curved artery with a stenosis at the inner wall. The numerical re-sults indicate a strong dependence of flow pattern on the blood viscosity and inlet flow rate, while the influence of the inlet flow profile to the flow pattem in downstream is negligible.

  3. Serum and urinary enzyme activities in renal artery embolism.

    Science.gov (United States)

    Donadio, C; Auner, I; Giordani, R; Lucchetti, A; Pentimone, F

    1986-10-31

    Renal artery embolism is not a rare occurrence, especially in patients with valvular heart disease, but the early diagnosis of this condition is infrequently accomplished. We report the clinical and laboratory data of 2 patients with valvular heart disease who presented with unilateral renal artery embolization. The usefulness of the determination of serum and urinary enzymes and renal function tests is discussed. We propose that these parameters support an earlier and more accurate diagnosis of renal artery embolism. PMID:2877758

  4. The renal arterial resistive index and stage of chronic kidney disease in patients with renal allograft

    DEFF Research Database (Denmark)

    Winther, Stine O; Thiesson, Helle C; Poulsen, Lene N;

    2012-01-01

    The study investigated the optimal threshold value of renal arterial resistive index as assessed by Doppler ultrasonography determining chronic kidney disease stage 4 or higher in patients with renal allograft.......The study investigated the optimal threshold value of renal arterial resistive index as assessed by Doppler ultrasonography determining chronic kidney disease stage 4 or higher in patients with renal allograft....

  5. The Role of Septal Perforators and “Myocardial Bridging Effect” in Atherosclerotic Plaque Distribution in the Coronary Artery Disease

    OpenAIRE

    Wasilewski, Jarosław; Roleder, Marcin; Niedziela, Jacek; Nowakowski, Andrzej; Osadnik, Tadeusz; Głowacki, Jan; Mirota, Kryspin; Poloński, Lech

    2015-01-01

    Summary The distribution of atherosclerotic plaque burden in the human coronary arteries is not uniform. Plaques are located mostly in the left anterior descending artery (LAD), then in the right coronary artery (RCA), circumflex branch (LCx) and the left main coronary artery (LM) in a decreasing order of frequency. In the LAD and LCx, plaques tend to cluster within the proximal segment, while in the RCA their distribution is more uniform. Several factors have been involved in this phenomenon...

  6. Predictors of atherosclerotic lesions of limb arteries according to cardioangiological screening of the adult population

    Directory of Open Access Journals (Sweden)

    R. A. Khokhlov

    2015-11-01

    Full Text Available Aim. To study the predictors of atherosclerotic lesions of arteries identified through a multi-channel volume sphygmography (MCVS. Material and methods. Simultaneous survey of 441 rural residents over 40 years old was performed. Synchronous registration of blood pressure (BP on four limbs using MCVS was fulfilled, and differences in systolic BP between arms (ΔSBParm and legs (ΔSBPleg were calculated. Ankle-brachial index (ABI was also evaluated. │ΔSBParm│≥15 mm Hg or │ΔSBPleg│≥15 mm Hg or ABI≤0.9 were considered as the markers of atherosclerotic arterial disease. Results. A significant asymmetry of SBP (≥15 mmHg was found in 7.7% [95% confidence interval (CI 5.5-10.6%] of patients in the upper limbs and in 6.8% (95 % CI 4.89.6% of patients in the lower extremities. The relative risk of asymmetry of SBP (≥15 mm Hg in the upper limbs increased in hypertension and obesity, and in the lower limbs in men and diabetes. Various quantitative risk factors of the onset and progression of atherosclerosis (age, body mass index, waist circumference, blood glucose, BP level had a positive correlation with the level of asymmetry of SBP on the limbs. Using MCVS and the appropriate combinations of features (SBP asymmetry or ABI≤0.9 allowed us at the stage of screening to find out blood flow disturbances in the arteries of the extremities in 14.7% (95% CI 11.7-18.4% of patients. This detection frequency was significantly higher than that when using only ABI. Conclusion. Identification of significant SBP asymmetry (≥15 mm Hg in the limbs may improve the diagnosis of atherosclerotic arterial disease at the stage of screening.

  7. STUDY ON VARIATIONS OF INFERIOR SEGMENTAL BRANCH OF RENAL ARTERY

    Directory of Open Access Journals (Sweden)

    Chandragirish S

    2014-11-01

    Full Text Available Background: The segmental arteries of the kidney supply the organ in such a way that, each renal pole receives its own artery while, the anterior portion between the poles is supplied by an upper and lower segmental vessel. These two arteries also include in their territory the lateral edge of the kidney and adjacent to the strip of parenchyma on the dorsal or posterior aspect of the organ. The knowledge of inferior segmental branch of renal artery is very important for surgeries in its distribution area in kidney. Materials and Methods: 100 kidneys (Fifty pairs intact with abdominal aorta were collected from department of Forensic medicine, JSS Medical College and Mysore Medical College. For study of segmental variation Corrosion cast technique method was used. The variations of inferior segmental branch of renal artery were observed and recorded. Results: In present study type I inferior segmental branch of renal artery were found in - 59% cases, type II in - 6% cases, type III in - 28% cases, type IV in - 2% cases. Conclusion: The inferior segmental artery from the anterior division of the renal artery is the commonest event –arising in 59%. This is Type I, the normal type. It arises from the renal artery (28% or from the posterior division (6% or from the aorta (2%. The knowledge of inferior segmental branch of renal artery helpful in kidney transplantation and renal surgery because these type of surgeries success mainly depends on arterial ligations.

  8. Hydronephrosis by an Aberrant Renal Artery: A Case Report

    OpenAIRE

    Park, Byoung Seok; Jeong, Taek Kyun; Ma, Seong Kwon; Kim, Soo Wan; Kim, Nam Ho; Choi, Ki Chul; Jeong, Yong Yeon

    2003-01-01

    Ureteropelvic junction obstruction is usually intrinsic and is most common in children. Aberrant renal arteries are present in about 30% of individuals. Aberrant renal arteries to the inferior pole cross anteriorly to the ureter and may cause hydronephrosis. To the best of our knowledge, although there are some papers about aberrant renal arteries producing ureteropelvic junction obstruction, there is no report of a case which is diagnosed by the new modalities, such as computed tomography an...

  9. Association of Atherosclerotic Peripheral Arterial Disease with Adiponectin Genes SNP+45 and SNP+276: A Case-Control Study

    Directory of Open Access Journals (Sweden)

    Claudia D. Gherman

    2013-01-01

    Full Text Available Objectives. We hypothesized that adiponectin gene SNP+45 (rs2241766 and SNP+276 (rs1501299 would be associated with atherosclerotic peripheral arterial disease (PAD. Furthermore, the association between circulating adiponectin levels, fetuin-A, and tumoral necrosis factor-alpha (TNF-α in patients with atherosclerotic peripheral arterial disease was investigated. Method. Several blood parameters (such as adiponectin, fetuin-A, and TNF-α were measured in 346 patients, 226 with atherosclerotic peripheral arterial disease (PAD and 120 without symptomatic PAD (non-PAD. Two common SNPs of the ADIPOQ gene represented by +45T/G 2 and +276G/T were also investigated. Results. Adiponectin concentrations showed lower circulating levels in the PAD patients compared to non-PAD patients (P0.05. Conclusion. The results of our study demonstrated that neither adiponectin SNP+45 nor SNP+276 is associated with the risk of PAD.

  10. Nuclear medicine and coronary artery disease: evaluation of tracers of myocardial perfusion and vulnerable atherosclerotic plaque

    International Nuclear Information System (INIS)

    Coronary artery disease is one of the primary cause of mortality worldwide. Nuclear medicine is the major imaging technique for diagnosis and following of this disease. perfusion: nowadays, major radioactive agents used in clinical practice are myocardial perfusion tracers. The reference tracer is thallium-201. However, 201Tl presents some drawbacks. 99mTcn-noet has been proposed for its replacement. This study shows that in contrast with previous studies realized in vitro on cardio myocytes, verapamil, an l-type calcium channel inhibitor, does not inhibit myocardial fixation of 99mTcn-noet in vivo in dog. This data is in agreement with the hypothesis of a non specific endothelial fixation of this tracer. Moreover, this study shows that as a pure tracer of myocardial perfusion, 99mTcn-noet can also be used to assess myocardial viability on a model of myocardial chronic infarction in rat. atherosclerosis: disruption of vulnerable atherosclerotic plaques is the main event leading to coronary accidents. The second part of this study concerns the evaluation of new potential tracers of the vulnerable atherosclerotic plaque in an experimental model of rabbit with an inheritable hypercholesterolemia. The four tracers evaluated (b2702(r), b2702-I, b2702-Tc and Tc-raft-b2702) are synthetic peptides comprising the residues 75-84 of hla-b2702, a molecule known to link vcam-1, an adhesion molecule expressed in vulnerable atherosclerotic plaque. The autoradiography studies show that all tracers accumulate within atherosclerotic plaque expressing vcam- and that. i-b2702 shows the best plaque/control fixation ratio. (author)

  11. Impaired renal allograft function is associated with increased arterial stiffness in renal transplant recipients

    DEFF Research Database (Denmark)

    Kneifel, M; Scholze, A; Burkert, A;

    2006-01-01

    It is important whether impairment of renal allograft function may deteriorate arterial stiffness in renal transplant recipients. In a cross-sectional study, arterial vascular characteristics were non-invasively determined in 48 patients with renal allograft using applanation tonometry and digital...... photoplethysmography. Mean age was 51 +/- 2 years (mean +/- SEM), and studies were performed 17 +/- 1 months after transplantation. The stage of chronic kidney disease was based on the glomerular filtration rate. We observed a significant association between the stage of chronic kidney disease and arterial stiffness...... of large arteries S1 and small arteries S2 in renal transplant recipients (each p older...

  12. Transcatheter Embolization of a Renal Arteriovenous Fistula Complicated by an Aneurysm of the Feeding Renal Artery

    International Nuclear Information System (INIS)

    Renal arteriovenous fistula (AVF) is rare. Renal AVF complicated by aneurysm of the feeding artery presents a technical challenge for endovascular treatment. We report a case managed by covered stenting of the renal artery aneurysm, coil embolization of the fistula, and bare stenting of the aorta

  13. Prognosis of non-significant coronary atherosclerotic disease detected by coronary artery tomography

    International Nuclear Information System (INIS)

    Introduction: Although studies have shown high diagnostic accuracy of coronary tomography (CT) in detecting coronary artery disease (CAD), data on the prognostic value of this method in patients with no significant coronary obstruction are limited. Objective: To evaluate the value of CT in predicting adverse events in patients with suspected CAD and no significant coronary obstruction. Methods: We prospectively evaluated 440 patients between January 2008 and July 2013 by MDCT, diagnosed with no significant obstruction or no atherosclerotic coronary obstruction with an average follow-up of 33 months. The outcomes evaluated were: cardiac death, myocardial infarction, unstable angina associated with hospitalization or coronary artery bypass grafting. Results: Of the 440 patients studied, 295 (67%) were men with mean age 55.9 ± 12.0 years. Non-significant obstruction was found in 152 (35%) of the patients and there were 49 (11%) outcomes. In the multivariate analysis using the Cox regression model, the predictors of clinical outcomes were non-significant obstruction on CT (hazard ratio 3.51; 95% CI 1.73 - 7.8; p <0.01), age and hypertension. Non-significant obstruction on CT was associated with adverse clinical outcomes and survival analysis showed a significant difference (log-rank 24.6; p <0.01) in predicting these outcomes. Conclusion: The detection of non-significant atherosclerotic obstruction by CT was associated with the presence of adverse events in patients with suspected CAD, which may prove useful in the risk stratification of these patients. (author)

  14. Prognosis of non-significant coronary atherosclerotic disease detected by coronary artery tomography

    Energy Technology Data Exchange (ETDEWEB)

    Barros, Marcio Vinicius Lins; Siqueira, Bruna Pinto; Guimaraes, Carolina Camargos Braichi; Cruz, David Filipe Silva; Guimaraes, Leiziane Assuncao Alves; Lima, Maicom Marcio Perigolo, E-mail: marciovlbarros@gmail.com [Faculdade de Saude e Ecologia Humana, Vespasiano, MG (Brazil); Nunes, Maria do Carmo Pereira [Universidade de Minas Gerais (UFMG), Belo Horizonte, MG (Brazil). Faculdade de Medicina; Siqueira, Maria Helena Albernaz [Hospital Materdei, Belo Horizonte, MG (Brazil)

    2015-07-15

    Introduction: Although studies have shown high diagnostic accuracy of coronary tomography (CT) in detecting coronary artery disease (CAD), data on the prognostic value of this method in patients with no significant coronary obstruction are limited. Objective: To evaluate the value of CT in predicting adverse events in patients with suspected CAD and no significant coronary obstruction. Methods: We prospectively evaluated 440 patients between January 2008 and July 2013 by MDCT, diagnosed with no significant obstruction or no atherosclerotic coronary obstruction with an average follow-up of 33 months. The outcomes evaluated were: cardiac death, myocardial infarction, unstable angina associated with hospitalization or coronary artery bypass grafting. Results: Of the 440 patients studied, 295 (67%) were men with mean age 55.9 ± 12.0 years. Non-significant obstruction was found in 152 (35%) of the patients and there were 49 (11%) outcomes. In the multivariate analysis using the Cox regression model, the predictors of clinical outcomes were non-significant obstruction on CT (hazard ratio 3.51; 95% CI 1.73 - 7.8; p <0.01), age and hypertension. Non-significant obstruction on CT was associated with adverse clinical outcomes and survival analysis showed a significant difference (log-rank 24.6; p <0.01) in predicting these outcomes. Conclusion: The detection of non-significant atherosclerotic obstruction by CT was associated with the presence of adverse events in patients with suspected CAD, which may prove useful in the risk stratification of these patients. (author)

  15. Comparison of MRI and DSA in assessment of carotid artery stenosis and atherosclerotic plaque

    International Nuclear Information System (INIS)

    Objective: To compare the efficacy of MRI and DSA in assessment of carotid artery stenosis and atherosclerotic plaque. Methods: Forty-six patients with carotid plaque detected by ultrasound were enrolled in this study, and 89 carotid arteries were evaluated by MRI and DSA. MRI examination was acquired with 3.0 T MR scanner and 8 channel phase-array surface coil. The MRI sequences consisted of pre-and post-contrast T1WI, T2WI, PDWI, TOF. Anterior-posterior and lateral views of carotid artery were performed on DSA. The degree of carotid artery stenosis was evaluated by the NASCET standard. Fibrous cap rupture, intraplaque hemorrhage, and calcification were also evaluated on MRI and DSA. Statistical comparison was performed with the Kappa value and paired Chi-square test. Results: The degree of carotid artery stenosis was 50% (16%-78%) on MRI and 47% (7%-73%) on DSA. Two imaging modalities were in good consistency in evaluation of the degree of stenosis (Kappa = 0.882, P2 =20.346, P<0.01). Furthermore, thirty-seven vessels with intraplaque hemorrhage and 71 vessels with calcification in the plaque were found on MRI but none on DSA. Conclusion: MRI is a reliable tool in assessment of the degree of the carotid stenosis and it is superior to DSA in detecting fibrous cap rupture, intraplaque hemorrhage, and calcification. (authors)

  16. Multiple vascular anomalies involving renal, testicular and suprarenal arteries

    Directory of Open Access Journals (Sweden)

    Suresh Rao

    2015-09-01

    Full Text Available Knowledge of variations of blood vessels of the abdomen is important during operative, diagnostic and endovascular pro- cedures. During routine dissection of the abdominal cavity, we came across multiple vascular anomalies involving renal, suprarenal and testicular arteries. The left kidney was supplied by two renal arteries originating together from the abdomi- nal aorta, and the right kidney was supplied by two accessory renal arteries, one of which was arising from the right renal artery and the other one from the aorta (about 2 inches below the origin of the renal artery. Accessory renal veins were present on both sides. The right testicular artery was arising from the lower accessory renal artery. The left testicular artery was looping around the inferior tributary of the left renal vein, whereby forming a sharp kink. The left middle suprarenal artery was diving into three small branches; the upper two branches were supplying the left suprarenal gland, whereas the lower branch was supplying the left kidney. Furthermore, detailed literature and the clinical and surgical importance of the case are discussed. [Arch Clin Exp Surg 2015; 4(3.000: 168-171

  17. Morphometric and hemodynamic analysis of atherosclerotic progression in human carotid artery bifurcations.

    Science.gov (United States)

    Huang, Xu; Yin, Xiaoping; Xu, Yingjin; Jia, Xinwei; Li, Jianhui; Niu, Pei; Shen, Wenzeng; Kassab, Ghassan S; Tan, Wenchang; Huo, Yunlong

    2016-03-01

    Although atherosclerosis has been widely investigated at carotid artery bifurcation, there is a lack of morphometric and hemodynamic data at different stages of the disease. The purpose of this study was to determine the lesion difference in patients with carotid artery disease compared with healthy control subjects. The three-dimensional (3D) geometry of carotid artery bifurcation was reconstructed from computed tomography angiography (CTA) images of Chinese control subjects (n = 30) and patients with carotid artery disease (n = 30). We defined two novel vector angles (i.e., angles 1 and 2) that were tangential to the reconstructed contour of the 3D vessel. The best-fit diameter was computed along the internal carotid artery (ICA) center line. Hemodynamic analysis was performed at various bifurcations. Patients with stenotic vessels have larger angles 1 and 2 (151 ± 11° and 42 ± 20°) and smaller diameters of the external carotid artery (ECA) (4.6 ± 0.85 mm) compared with control subjects (144 ± 13° and 36 ± 16°, 5.2 ± 0.57 mm) although there is no significant difference in the common carotid artery (CCA) (7.1 ± 1.2 vs. 7.5 ± 1.0 mm, P = 0.18). In particular, all patients with carotid artery disease have a stenosis at the proximal ICA (including both sinus and carina regions), while 20% of patients have stenosis at the middle ICA and 20% have stenosis expansion to the entire cervical ICA. Morphometric and hemodynamic analyses suggest that atherosclerotic plaques initiate at both sinus and carina regions of ICA and progress downstream. PMID:26747497

  18. One Year Clinical Outcomes of Renal Artery Stenting: The Results of ODORI Registry

    International Nuclear Information System (INIS)

    The safety, efficacy and long term clinical benefits of renal artery revascularization by stenting are still a matter of debate. The aim of our study was to define the safety and efficacy of renal artery stenting with the Tsunami peripheral stent (Terumo Corporation, Tokyo, Japan). The ODORI was a prospective, multicentre registry which enrolled 251 consecutive patients, (276 renal arteries) in 36 centres across Europe. The primary endpoint was acute procedural success defined as <30% residual stenosis after stent placement. Secondary endpoints included major adverse events, blood pressure control, serum creatinine level, and target lesion revascularization (TLR) at 6 and 12 months. Patients were 70 ± 10 years old, 59% were male, 33% had diabetes, and 96% hypertension. The main indications for renal stent implantation were hypertension in 83% and renal salvage in 39%. Direct stent implantation was performed in 76% of the cases. Acute success rate was 100% with residual stenosis of 2.5 ± 5.4%. Systolic/diastolic blood pressure decreased from a mean of 171/89 at baseline to 142/78 mmHg at 6 months (p < 0.0001 vs. baseline), and 141/80 mmHg at 12 months (p < 0.0001 vs. baseline). Mean serum creatinine concentration did not change significantly in the total population. However, there was significant improvement in the highest tercile (from 283 μmol/l at baseline to 205 and 209 μmol/l at 6 and 12 months respectively). At 12-months, rates of restenosis and TLR were 6.6 and 0.8% respectively. The 12 month cumulative rate of all major clinical adverse events was 6.4% while the rate of device or procedure related events was 2.4%. In hypertensive patients with atherosclerotic renal artery stenosis Tsunami peripheral balloon-expandable stent provides a safe revascularization strategy, with a potential beneficial impact on hypertension control and renal function in the highest risk patients.

  19. Is it renal colic or ruptured dissecting aneurysm of renal artery?: A case report

    OpenAIRE

    Marwah, Sanjay; Singla, Sham; Kalra, Rajnish; Marwah, Nisha; Singh, Shashi Pratap

    2009-01-01

    Introduction The dissecting aneurysm of renal artery is a form of renal artery occlusive disease that is infrequently recognized in the literature. However, when encountered, it is of great clinical significance because symptoms related to aneurysm are rarely seen and there is risk of its rupture. Case Presentation The present case was a 30 year old Indian male, who presented with recurrent episodes of pain mimicking renal colic, which turned out to be a ruptured dissecting aneurysm of renal ...

  20. Importance of atherosclerotic stenotic lesion of the brachiocephalic arteries in the development of cognitive impairments

    Directory of Open Access Journals (Sweden)

    D. R. Khasanova

    2015-03-01

    Full Text Available The impact of the pattern of atherosclerotic stenotic lesion on the clinical presentation of cognitive impairments (CIs has been inadequately investigated. Objective: to estimate the impact of the degree and site of an atherosclerotic stenotic process on cerebral perfusion and cognitive functions. Patients and methods. A total of 123 patients (65 men and 58 women aged 50 to 75 years with brachiocephalic artery stenosis of at least 40%, without hypertension, diabetes mellitus, or other systemic vascular pathology were examined. The structural state of the brain substance and the state of cerebral blood flow were evaluated by magnetic resonance imaging and magnetic resonance angiography. The scale described by P. Scheltens et al. was used to determine changes in the white matter. The site and degree of a stenotic process were estimated by extracranial and transcranial duplex scanning. CIs were identified applying a set of neuropsychological assessment scales. The Hamilton hospital depression rating scale was also employed. Results and discussion. Varying degrees of CIs were detected in the majority of the examinees with brachiocephalic artery atherosclerosis. The most severe CIs were associated with the involvement of parietal and frontal lobes. There was significant deterioration in cognitive functions with a higher percentage of stenosis: more severe CIs were seen in the presence of stenosis in the carotid system than in those in the vertebrobasilar bed. In addition, the patients with concomitant stenoses and tandem stenoses were observed to have more pronounced CIs than those with single artery stenosis. Cerebral atherosclerosis is shown to be one of the major risk factors for CIs. Not only the degree of stenoses, but also to a greater extent their site was observed to impact the occurrence of CIs accompanied by the development of a perfusion deficit in the specific vascular beds. The determination of the pattern of a stenotic process will be

  1. Local blood pressure associates with the degree of luminal stenosis in patients with atherosclerotic disease in the middle cerebral artery

    OpenAIRE

    Jiang, Yuanliang; Peng, Wenjia; Teng, Zhongzhao; Gillard, Jonathan H.; Hong, Bo; Liu, Qi; Lu, Jianping

    2016-01-01

    The mechanism underlying atherosclerotic ischemic events within the middle cerebral artery (MCA) is unclear. High structural stress induced by blood pressure might be a potential aetiology as plaque rupture occurs when such mechanical loading exceeds its material strength. To perform reliable analyses quantifying the mechanical loading within a plaque, the local blood pressure is needed. However, data on MCA blood pressure is currently lacking. In this study, the arterial pressure proximal to...

  2. Surgical complications after renal transplantation in grafts with multiple arteries

    Directory of Open Access Journals (Sweden)

    Eduardo Mazzucchi

    2005-04-01

    Full Text Available INTRODUCTION: Renal transplantation with multiple arteries appears, in literature, associated to a major index of surgical complications. This study compared the surgical complications and short-term outcome renal transplants with multiple arteries and single artery grafts. MATERIALS AND METHODS: The data of 64 renal transplants with multiple arteries performed between January 1995 and December 1999 were compared to the ones of 292 transplants with single renal artery. The aspects analyzed were number of arteries of the graft, donor type, vascular reconstruction technique, the occurrence of surgical complications, the incidence of delayed graft function, graft function 1 month after transplantation, graft loss and the patients' deaths. RESULTS: The incidence of surgical complications in grafts with multiple arteries and single renal artery was respectively: vascular - 3.1% and 3.1%; urological - 6.3% and 2.7% and other surgical complications - 15.6% and 10.6%, respectively. The incidence of lymphoceles was 3.1% in grafts with a single artery and 12.5% in grafts with more than 1 artery (p = 0.0015. The incidence of delayed graft function in grafts with multiple arteries and with a single renal artery was respectively 35.1 and 29.1% (p = 0.295. Mean serum creatinine at the 30th postoperative day was 2.46 and 1.81 in grafts with multiple and with 1 artery, respectively (p=0.271. CONCLUSIONS: Kidney transplantation using grafts with single and multiple arteries present similar indexes of surgical complications and short-term outcome; lymphoceles were more frequent among grafts with multiple arteries.

  3. Power doppler ultrasound findings of renal infarct after experimental renal artery occlusion: comparison with spiral CT

    International Nuclear Information System (INIS)

    To evaluate the efficacy of power Doppler ultrasonography (PDUS) in depicting renal infarction in rabbits during experimental renal segmental arterial occlusion, and to compare the results with those of CT scanning. In 28 rabbits weighing 2.5 4kg, the segmental renal artery was occluded through the left main renal artery by embolization with Ivalon (Nycomed, Paris, France). Power Doppler ultrasonography and spiral CT scanning were performed before and at 2, 5, 8, 15, and 24 hours, and 3 and 7 days after occlusion of the segmental renal artery. The location of infarcted areas and collaterals, as seen on PDUS and CT scans, was evaluated by two radiologists. In all cases, as seen on power Doppler ultrasonography, infarcted areas-when compared with normal parenchyma, clearly demonstrated wedge-shaped perfusion defects in the kidney. The location of the lesion closely corresponded to the location seen during CT scanning. After renal arterial occlusion, transiently congested capsular arteries, which were named 'capsular sign', were seen in 63% of rabbits in the two and five-hour groups. No significant cortical rim sign was demonstrated on power Doppler ultrasonography, though it was noted on spiral CT at 15 and 24 hours, and 3 and 7 days after renal arterial occlusion. Power Doppler ultrasonography was useful for the diagnosis of renal infarction. Congested capsular artery seen in the early stage of renal infarction might be a characteristic finding of this condition, as seen on power Doppler ultrasonography

  4. Treatment of hypertension in patients with renal artery stenosis due to fibromuscular dysplasia of the renal arteries

    OpenAIRE

    Chrysant, Steven G; Chrysant, George S.

    2014-01-01

    Renal artery stenosis (RAS) from fibromuscular dysplasia (FMD) is an uncommon cause of hypertension that affects mostly women. FMD is a noninflammatory vascular disease that predominantly affects mainly the renal arteries, but can also affect arteries in other vascular territories. The most common type of FMD is the media fibroplasia with the characteristic “string of beads” appearance (80-90%), whereas the two other types, the “intimal” and “adventitial” FMD are much less common accounting f...

  5. Assessment of atherosclerotic plaque vulnerability of coronary arteries in cases of sudden cardiac death

    International Nuclear Information System (INIS)

    To study the plaque vulnerability in coronary arteries taken from autopsy specimens, of individuals dying of ischemic heart disease in our setup and to compare it with atheroma of those who died of non-cardiac causes. Sixty coronary arteries having atherosclerosis, from autopsies of patients who died of sudden cardiac death were divided into case and control groups. Case group included thirty coronary arteries having atherosclerosis from autopsies of patients of whose death was attributable to Ischemic Heart Disease (IHD). Control group included thirty coronary arteries where atherosclerotic changes were found by chance (death not attributable to ischemic heart disease). Plaques were assessed for fibrous cap thickness, foam cells; mean percentage of inflammatory cells on Haemotoxylin and Eosin (H and E) stained slides whereas immunohistochemical (IHC) markers for T-Cells were done by IHC stain method. In present study, foam cells are significantly more in study group than in control group (P=0.007). Fibrous cap thickness fulfilling the criteria of vulnerable plaque was more in study group as compared to control group (P<0.001). The present study demonstrated that there was insignificant difference (P=0.152), in the mean percentage of inflammatory cells in case group and control group. An overall significant association was found between vulnerable plaque and death due to ischemic heart disease (P<0.001). Conclusion: Patients dying of ischemic heart disease have more vulnerable plaque in their coronary arteries as compared to those dying from non ischemic cause. Although this is an autopsy study but the significance of in this study can be very important to guide cardiologists to identify patients at high risk of acute coronary syndrome and use new diagnostic modalities like intravascular ultrasonography and therapeutic strategies like genomic and proteomic techniques. This will help the early detection and treatment of such cases and may ultimately reduce the

  6. Advances in radiological imaging of the renal arteries and veins

    International Nuclear Information System (INIS)

    Familiarity with the normal anatomy of the renal vessels and common variants is of particular importance for the operator who performs renal transplantation or therapeutic interventions in the renal vessels. Because of the recent major advances in multislice spiral computed tomography angiography (MSCTA) techniques, our ability has been considerably improved to determine the patterns and characters of renal arteries and veins. This article summarizes the research situation and progress in the area of renal vessel imaging anatomy. Some regularity in the distribution of renal vessel positions, dimensions and variations among patients who received MSCTA examinations, and these anatomical measurements are of great value for clinical diagnosis and treatment. (authors)

  7. Treatment of non-neoplastic renal hemorrhage with segmental embolization of renal artery

    International Nuclear Information System (INIS)

    Objective: To explore the value of segmental embolization of renal artery in dealing with non- neoplastic renal hemorrhage. Methods: Four cases of non-neoplastic hemorrhage, including 2 with bleeding after renal acupuncture biopsy, 2 with bleeding after nephrolithotomy and 1 with congenital renal arteriovenous malformation, were treated with superselective segmental embolization of renal artery. 2 were embolized with coil, 1 with alcohol plus coil and 1 with PVA parcels. Results: Hematuria disappeared in 1-3 days. There was no recurrence in 7-45 months follow up and no complications induced by embolization. Conclusion: It is a safe and reliable therapy to treat non-neoplastic renal hemorrhage with segmental embolization of renal artery. (authors)

  8. A large unilateral renal artery aneurysm in a young child

    International Nuclear Information System (INIS)

    The case of a 13-month-old boy with fibromuscular dysplasia (FMD) presenting with a large saccular aneurysm of the left renal artery and renovascular hypertension is reported. Renal and intrarenal arteries showed numerous small aneurysms alternating with stenoses. All arterial lesions were localized to the left kidney. After left nephrectomy, the patient's blood pressure normalized. Histopathologic examination of the arteries disclosed changes typical of medial fibroplasias, the most frequently described form of FMD in children. This diagnosis is rewarding as it represents a surgically curable cause of severe hypertension. (orig.)

  9. Analysis of haemodynamic disturbance in the atherosclerotic carotid artery using computational fluid dynamics.

    Science.gov (United States)

    Birchall, Daniel; Zaman, Azfar; Hacker, Jacob; Davies, Gavin; Mendelow, David

    2006-05-01

    Computational fluid dynamics (CFD) provides a means for the quantitative analysis of haemodynamic disturbances in vivo, but most work has used phantoms or idealised geometry. Our purpose was to use CFD to analyse flow in carotid atherosclerosis using patient-specific geometry and flow data. Eight atherosclerotic carotid arteries and one healthy control artery were imaged with magnetic resonance angiography (MRA) and duplex ultrasound, and the data used to construct patient-specific computational models used for CFD and wall shear stress (WSS) analysis. There is a progressive change in three-dimensional (3-D) velocity profile and WSS profile with increasing severity of stenosis, characterised by increasing restriction of areas of low WSS, change in oscillation patterns, and progressive rise in WSS within stenoses and downstream jets. Areas of turbulent, retrograde flow and of low WSS are demonstrated in the lee of the stenoses. This study presents the largest CFD analysis of abnormal haemodynamics at the atheromatous carotid bifurcation using patient-specific data and provides the basis for further investigation of causal links between haemodynamic variables and atherogenesis and formation of unstable plaque. We propose that this provides a means for the prospective assessment of relative stroke risk in patients with carotid atherosclerosis. PMID:16402252

  10. Analysis of haemodynamic disturbance in the atherosclerotic carotid artery using computational fluid dynamics

    International Nuclear Information System (INIS)

    Computational fluid dynamics (CFD) provides a means for the quantitative analysis of haemodynamic disturbances in vivo, but most work has used phantoms or idealised geometry. Our purpose was to use CFD to analyse flow in carotid atherosclerosis using patient-specific geometry and flow data. Eight atherosclerotic carotid arteries and one healthy control artery were imaged with magnetic resonance angiography (MRA) and duplex ultrasound, and the data used to construct patient-specific computational models used for CFD and wall shear stress (WSS) analysis. There is a progressive change in three-dimensional (3-D) velocity profile and WSS profile with increasing severity of stenosis, characterised by increasing restriction of areas of low WSS, change in oscillation patterns, and progressive rise in WSS within stenoses and downstream jets. Areas of turbulent, retrograde flow and of low WSS are demonstrated in the lee of the stenoses. This study presents the largest CFD analysis of abnormal haemodynamics at the atheromatous carotid bifurcation using patient-specific data and provides the basis for further investigation of causal links between haemodynamic variables and atherogenesis and formation of unstable plaque. We propose that this provides a means for the prospective assessment of relative stroke risk in patients with carotid atherosclerosis. (orig.)

  11. Analysis of haemodynamic disturbance in the atherosclerotic carotid artery using computational fluid dynamics

    Energy Technology Data Exchange (ETDEWEB)

    Birchall, Daniel [Newcastle General Hospital, Division of Neuroradiology, Regional Neurosciences Centre, Newcastle-upon-Tyne (United Kingdom); Zaman, Azfar [Regional Cardiothoracic Centre, Division of Cardiology, Newcastle-upon-Tyne (United Kingdom); Hacker, Jacob; Davies, Gavin [Arup Research and Development, London (United Kingdom); Mendelow, David [Regional Neurosciences Centre, Divisions of Neurosurgery, Newcastle-upon-Tyne (United Kingdom)

    2006-05-15

    Computational fluid dynamics (CFD) provides a means for the quantitative analysis of haemodynamic disturbances in vivo, but most work has used phantoms or idealised geometry. Our purpose was to use CFD to analyse flow in carotid atherosclerosis using patient-specific geometry and flow data. Eight atherosclerotic carotid arteries and one healthy control artery were imaged with magnetic resonance angiography (MRA) and duplex ultrasound, and the data used to construct patient-specific computational models used for CFD and wall shear stress (WSS) analysis. There is a progressive change in three-dimensional (3-D) velocity profile and WSS profile with increasing severity of stenosis, characterised by increasing restriction of areas of low WSS, change in oscillation patterns, and progressive rise in WSS within stenoses and downstream jets. Areas of turbulent, retrograde flow and of low WSS are demonstrated in the lee of the stenoses. This study presents the largest CFD analysis of abnormal haemodynamics at the atheromatous carotid bifurcation using patient-specific data and provides the basis for further investigation of causal links between haemodynamic variables and atherogenesis and formation of unstable plaque. We propose that this provides a means for the prospective assessment of relative stroke risk in patients with carotid atherosclerosis. (orig.)

  12. Renal artery stenosis after radiotherapy for Ewing's sarcoma

    International Nuclear Information System (INIS)

    Background: the fact that therapeutic irradiation can induce significant stenosis in the arteries of the head, neck, and chest, as welt as in the aorta and the iliac arteries, is familiar in daily practice and well documented in the literature. By contrast, radiation-induced renal artery stenosis seems to be a less widely known complication. Patients and methods: the sudden onset of medically refractory arterial hypertension and coma in a 27-year-old man is reported, who had been treated at age 20 with chemotherapy and radiotherapy for Ewing's sarcoma in the lumbar region. This treatment had been performed at the hospital of Sion, Switzerland in 2001. Also, the relevant literature from 1965 to 2007 is reviewed to underscore various aspects of this problem and to demonstrate the clinical relevance of renal artery stenosis as a potential long-term sequela of radiotherapy. Conclusion: radiation-induced renal artery stenosis has only rarely been described in the literature, but arterial hypertension due to radiation-induced renal artery stenosis is a serious long-term sequela that can appear at a latency of up to 20 years after treatment. The paucity of reports presumably reflects the lesser frequency of radiotherapy for retroperitoneal tumors as compared to head-and-neck cancers, as well as lower awareness of the problem due to diagnostic bias in the era before CT and MRI were in routine use: at that time, carotid artery stenosis was easy to diagnose by ultrasonography, while radiation-induced renal artery stenosis, whose real incidence may well be higher, probably often went undetected. Thus, when a patient with a history of abdominal or retroperitoneal radiotherapy unexpectedly develops intractable hypertension, radiation-induced renal artery stenosis must be included in the differential diagnosis. (orig.)

  13. Dependence of renal blood flow on renal artery stenosis measured using CT angiography

    Energy Technology Data Exchange (ETDEWEB)

    Luedemann, Lutz [Charite - Universitaetsmedizin Berlin (Germany). Dept. of Radiotherapy; Nafz, B.; Persson, P. [Charite - Universitaetsmedizin Berlin (Germany). Inst. for Vegetative Physiology; Elsner, F. [Krankenhaus am Urban, Berlin (Germany). Dept. of Anesthesiology; Grosse-Siestrup, C.; Meissler, M. [Charite - Universitaetsmedizin Berlin (Germany). Experimental Animal Unit; Gutberlet, M. [Charite - Universitaetsmedizin Berlin (Germany). Dept. of Diagnostic and Interventional Radiology; Univ. Leipzig/ Leipzig Heart Center (Germany). Dept. of Diagnostic and Interventional Radiology; Lengsfeld, P.; Voth, M. [Bayer-Schering Pharma AG, Berlin (Germany). Global Medical Affairs Diagnostic Imaging

    2011-03-15

    The present study investigates the suitability of computed tomography angiography (CTA) depicting the degree of renal artery stenosis for estimating renal blood flow (RBF) in a kidney. Materials and Methods: We investigated renal artery stenosis assessment by CTA in eight adult female hybrid pigs with an ultrasound probe implanted at the renal vein for RBF measurement. An inflatable metal-free cuff was placed around the renal artery to control the RBF. The RBF was then reduced in four steps. For each reduced RBF value and baseline RBF, CTA with a reconstructed slice thickness of 0.625 mm was performed in the arterial phase following injection of 80 ml of nonionic intravenous contrast medium. The radius of the stenotic and non-stenotic renal artery segment was measured in the reconstructed images. Results: A significant linear correlation (p < 0.0001) was found between the relative apparent stenosis (calculated as the ratio of the radii of the actual stenotic segment and a non-stenotic renal artery segment) and RBF. The linear regression yielded a slope of 0.57 and a y-axis of 24.1 %. A significant linear correlation (p < 0.0001) was also found between the relative true stenosis (the ratio of the radii of the actual stenotic segment and a non-stenotic renal artery segment at baseline) and the RBF. The linear regression yielded a slope of 0.67 and a y-axis of 13.8 %. Conclusion: The results show that the relative stenosis apparent on CTA differs from the true degree of renal artery stenosis. Nevertheless, the degree of renal artery stenosis determined by CTA provides a reliable estimate of the resulting RBF reduction. (orig.)

  14. The medical management of renal artery stenosis in transplant recipients.

    Science.gov (United States)

    Jachuck, S J; Wilkinson, R; Uldall, P R; Elliott, R W; Taylor, R M; Hacking, P M

    1979-01-01

    The investigation, management and clinical course of 12 patients developing stenosis of the renal artery following transplantation are described. The possible aetiology of the three arteriographic patterns of stenosis is discussed. Surgical correction of graft arterial stenosis is difficult and may lead to graft loss, whereas the outcome with antihypertensive drug treatment with or without anticoagulants is good. Surgery should only be contemplated if medical treatment is failing or if renal function is deteriorating. PMID:369641

  15. Interventional treatment of transplant renal artery stenosis

    International Nuclear Information System (INIS)

    Objective: To analyze the treatment of transplant renal artery stenosis (TRAS) by percutaneous transluminal angioplasty (PTA) and stents. Methods: The average time from transplantation to the symptom of TRAS was 6.6 month (3-15 month) in 21 TRAS patients. BP and creatinine level were recorded before and after the procedure. PTA was performed with ordinary balloon (5 F, length 20-30 mm) and/or small balloon (2.6 F, length 36 mm) in all patients, and stents were embedded in 5 of them. Results: A total of 32 PTA were successfully performed (1 time, 13 cases; 2 times, 5 cases, and 3 times, 3 cases) by femoral approach (22) and brachial approach (10). Stenosis were significantly decreased from 79%-97% pre-PTA to 10%-30% post-PTA. Systolic pressure decreased from 170 mmHg (150-210 mmHg) pre-PTA to 135 mmHg (100-190 mmHg) post-PTA and diastolic pressure decreased from 120 mmHg (90-145 mmHg) to 85 mmHg (80-125 mmHg). Restenosis rates was 38% after first PTA and 14% after second time. 4 self-expandable stents (Wallstent) and 1 balloon-dilatation stent (Palmaz) were released in 5 cases. There were healing (n=6), melioration (n=8), improvement (n=5), and inefficiency (n=2) after follow-up of 23 months (3-60 month). No complication was found except puncture hematoma by the brachial artery approach in 1 case. Conclusion: PTA is safe and effective in the treatment of TRAS and high rates of procedure success may be achieved with the help of brachial approach and small balloon catheter. Reasonable use of stents is beneficial in decreasing the restenosis rates. (authors)

  16. Super-selective renal artery embolization for the treatment of acute renal hemorrhage

    International Nuclear Information System (INIS)

    Objective: To evaluate super-selective renal artery embolization in treating acute renal hemorrhage. Methods: A total of 17 patients with massive renal bleeding were enrolled in this study. After super-selective renal artery catheterization with 4 F and/or 2.7 F catheter was accomplished, renal artery embolization with microcoils, coils and/or PVA particles was carried out. Preoperative CTA was performed in five patients. Plain CT scanning and contrast-enhanced CTA were employed in nine patients at 4 days to 54 months after treatment. Results: Technical success was achieved in all of the 17 cases. Pre-interventional CT scan showed abnormal signs of hemorrhage, arteriovenous malformation, aneurysm, etc. Post-interventional CT scan showed different degrees of renal infarction, renal atrophy, peripheral contraction and depression of the kidney which were located in the areas originally supplied by embolized artery. Compensatory hypertrophy of the contralateral normal kidney occurred in four cases. Abnormal blood vessels disappeared in post-interventional CTA. No coil displacement was seen. Conclusion: For the treatment of acute renal hemorrhage super-selective renal artery embolization is safe and reliable. CTA is of great significance for identifying the bleeding sites before interventional treatment and for evaluating the therapeutic effect. (author)

  17. Interventional therapy of renal artery stenosis in kidney transplants

    International Nuclear Information System (INIS)

    Objective: To evaluate efficacy of percutaneous transluminal angioplasty (PTA) and stenting for treatment of transplanted renal artery stenosis (TRAS). Method: Seven patients with TRAS were included in this study. By femoral or axillary approach, balloon angioplasty and/or metallic stents placement at stenotic renal artery were performed. Results: Of the seven patients, balloon angioplasty was carried out in 3 (2 cases via femoral artery, 1 via axillary artery), both balloon angioplasty and metallic stents placement were performed in 4 (2 via femoral artery, 2 via axillary artery). After the procedure, blood pressure recovered to normal in 5 cases, controlled with administration of antihypertensive in the other 2 cases. By 9 to 36 month's follow-up, restenosis of renal artery occurred in only 1 case at 9 months after stent implantation. The second balloon angioplasty were taken and better renal artery blood flow was obtained in this case. Other 6 cases showed no restenosis. Conclusion: PTA and stents placement were effective and safe approach in treatment of TRAS. Further investigation was needed to prevent and manage restenosis after these procedures

  18. Left testicular artery arching over the ipsilateral renal vein

    Institute of Scientific and Technical Information of China (English)

    Munekazu Naito; Hayato Terayama; Yoichi Nakamura; Shogo Hayashi; Takayoshi Miyaki; Masahiro Itoh

    2006-01-01

    Aim: To report two cases of the left testicular artery arching over the left renal vein (LRV) before running downward to the testis. Methods: The subjects were obtained from two Japanese cadavers. During the student course of gross-anatomical dissection, the anatomical relationship between the testicular vessels and the renal vein was specifically observed. Results: The arching left testicular artery arose from the aorta below the LRV and made a loop around the LRV, which appeared to be mildly compressed between the arching artery and the psoas major muscle.Conclusion: Clinically, compression of the LRV between the abdominal aorta and the superior mesenteric artery occasionally induces LRV hypertension, resulting in varicocele, orthostatic protenuria and hematuria. Considering that the incidence of a left arching testicular artery is higher than that of a right one, an arching left artery could be an additional cause of LRV hypertension.

  19. [Feasibility study of the Doppler exploration of the renal artery].

    Science.gov (United States)

    Milon, P; Clavier, E; Genevois, A; Benozio, M

    1990-03-01

    Using arteriography as a reference, the authors investigate the feasibility of pulsed doppler exploration of the normal or pathological renal arteries in 46 successive patients. The poor sensitivity of pulsed doppler, mainly due to the considerable anatomical variations of the renal pedicle, does not currently allow using this technique for the detection of renal arterial stenosis. When combined with angiography, pulsed doppler becomes a definite asset in therapeutic radiology to help in the choice of a treatment and in follow-up. PMID:2191123

  20. Radiation induced renal arterial stenosis detected by color duplex ultrasonography: case report

    Institute of Scientific and Technical Information of China (English)

    Jing Gao; Byong K Park; Arnold Alday

    2005-01-01

    Renal artery stenosis as a complication from radiation therapy is not common, but it is life threatening and needs to be corrected urgently in order to prevent renal failure even losing kidney. The diagnostic criteria of renal artery stenosis in the adults by color duplex ultrasonography have been established, which may play an important role in screening radiation induced renal artery stenosis.

  1. Comparison between Adventitial and Intimal Inflammation of Ruptured and Nonruptured Atherosclerotic Plaques in Human Coronary Arteries

    Directory of Open Access Journals (Sweden)

    Higuchi Maria L.

    2002-01-01

    Full Text Available OBJECTIVE: To verify the possible role of adventitial inflammation in atherosclerotic plaque vulnerability and coronary artery remodelling. METHODS: We compared the mean numbers of lymphocytes in the adventitia and in the plaque of ruptured thrombosed and stable equi-stenotic coronary segments of 34 patients who died due to acute myocardial infarction. We also analysed adventitial microvessels, adventitial fibrosis and the external elastic membrane. RESULTS: In the adventitia, the numbers of lymphocytes and microvessels/mm² were 69.5±88.3 and 60.9± 32.1 in culprit lesions and 16.4 ± 21.1 and 44.3±16.1 in stable lesions (p<0.05; within the plaques, the mean number of lymphocytes was 24±40.8 in culprit lesions and 10.9±13.2 in stable ones (p=0.17. The mean percent area of adventitial fibrosis/cross-sectional area of the vessel was significantly lower in unstable plaques (p<0.001. The confocal images showed holes in the external elastic membrane. CONCLUSION: Unstable plaques exhibit chronic pan-arteritis, accompanied by enlargement, medial thinning, and less fibrosis than in stable lesions, which is compatible with vessel aneurysm. Adventitial inflammation may contribute significantly to atheroma instability.

  2. Interventional treatment of transplanted renal artery stenosis

    International Nuclear Information System (INIS)

    Objective: To analyze the treatment of transplant renal artery stenosis (TRAS) by percutaneous transluminal angioplasty (PTA) and stenting. Methods: The average time duration from transplantation to the on set symptom of TRAS was 6.9 months (3-18 months) in 35 TRAS patients. BP and creatinine level were recorded before and after the procedure. PTA was performed through contralateral femoral or left brachial approach with ordinary balloon (5 F, length 20-30 mm) and/or small balloon catheters (2.6 F, length 36 mm) in all patients, and stents were embedded in 11 of them. Results: A total of 46 PTA were successfully performed (1 time, 20 cases; 2 times, 12 cases, and 3 times, 3 cases) via contralateral femoral approach (26) and left brachial approach (15). Stenosis were significantly decreased from 75%-98% pre-PTA to 10%-30% post-pTA.Systolic pressure decreased from 170 mmHg (150-210 mmHg) pre-pTA to 135 mmHg (100-190 mmHg) post-PTA and diastolic pressure decreased from 120 mmHg (90-145 mmHg) to 85 mmHg (80-125 mmHg) respectively. Restenosis rates were 39% after first PTA and 15% after the second time. All 46 times of PTA used 26 ordinary balloon catheters and 20 microballoon catheters. 8 self-expandable stents (Wallstent) and 3 balloon-dilatation stents (Palmaz) were released in 11 cases. There were healed case (n=11), melioration (n=15), improvement (n=7), and inefficiency (n=2) after follow-up of 23 months (3-60 month). No complication occured except puncture site hematoma via the brachial artery approach in 1 case. Conclusions: PTA is safe and effective in the treatment of TRAS and high rate of procedure success may be achieved with the help of brachial approach and micro-balloon catheter. Reasonable use of stents is beneficial in decreasing the restenosis. (authors)

  3. Study of pomegranate (Punica granatum L.) peel extract containing anthocyanins on fatty streak formation in the renal arteries in hypercholesterolemic rabbits

    OpenAIRE

    Fatemeh Sharifiyan; Ahmad Movahedian-Attar; Nafiseh Nili; Sedigheh Asgary

    2016-01-01

    Background: The influence of the supplementation of pomegranate peel extract containing anthocyanins on atherosclerotic plaque formation induced by hypercholesterolemia was investigated in renal arteries in rabbits. Materials and Methods: After the determination of polyphenol and anthocyanin′s content of P. granatum peel hydroalcoholic extract, 30 male rabbits were randomly divided into three groups. They were fed basic diet, hypercholesterolemic diet and hypercholesterolemic diet along w...

  4. Interventional treatment of transplanted renal artery stenosis

    International Nuclear Information System (INIS)

    Objective: To evaluate the treatment of transplanted renal artery stenosis (TRAS) by pereutaneous transluminal angioplasty (PTA)and stentplacement. Methods: The averange time from trans- plantation to the symptom occurrence of TRAS was 5.5 months (4-15 months)in 12 TRAS patients. All of them received the interventional therapy through femoral approach. Average BP, creatinine level and stenosis before and after the procedure were taken as the judgement standards. Results: PTA was performed with balloon (length 20-40 mm, diameter 5-7 mm)in 4 patients, stenting after PTA in 5, including 3 of direct stenting. Two cases (17%)occurred restenosis after PTA and restenting was undertaken. Three ases (25%)with restenosis after stentplacement were undergone PTA. One self-expandable stent and 9 balloon- dilatation stent were released in 10 eases. Stenosis significantly decreased from 65%-95% preoperatively to 15%-25% postoperatively, together with average BP decreased from 175/105 mmHg to 140/80 mmHg and creatinine level decreased from 475.5 μmol/L to 118.5 μmol/L. Among 12 cases included 4 healed, melioration (5), improvement (2), and inefficiency (1) during follow-up of 9 months (3-24 months). No complication occurred. Conclusion: The interventional therapy is effective and safe for TRAS with high rates of procedure success and efficacy. The proper selection of the adapted approach combined with PTA and stenting may effectively raise the long term efficacy for TRAS and success rate of the procedure. (authors)

  5. Non-enhanced MR angiography of renal arteries - Comparison with contrast-enhanced MR angiography

    Energy Technology Data Exchange (ETDEWEB)

    Angeretti, M. G.; Lumia, D.; Cani, A.; Barresi, M.; Cardim, L Nocchi; Piacentino, F.; Genovese, E. A.; Fugazzola, C. [Dept. of Radiology, Insubria Univ., Ospedale di Circolo e Fondazione Macchi, Varese (Italy)], e-mail: laranocchi@gmail.com; Maresca, A. M. [Dept. of Internal Medicine, Insubria Univ., Ospedale di Circolo e Fondazione Macchi, Varese (Italy); Novario, R. [Dept. of Medical Physics, Insubria Univ., Ospedale di Circolo e Fondazione Macchi, Varese (Italy)

    2013-09-15

    Background: The main causes of renal artery stenosis (RAS) are atherosclerosis and fibromuscular dysplasia. Despite contrast-enhanced magnetic resonance angiography (CE-MRA) being a safe and reliable method for diagnosis of RAS especially in young individuals, recently it has been possible to adopt innovative technologies that do not require paramagnetic contrast agents. Purpose: To assess the accuracy of steady-state free-precession (SSFP) non-contrast-enhanced magnetic resonance angiography (NC-MRA) by using a 1.5 T MR scanner for the detection of renal artery stenosis, in comparison with breath-hold CE-MRA as the reference standard. Material and Methods: Sixty-three patients (33 men, 30 women) with suspected renovascular hypertension (RVHT) were examined by a 1.5T MR scanner; NC-MRA with an electrocardiography (ECG)-gated SSFP sequence was performed in 58.7% (37/63) of patients; in 41.3% (26/63) of patients a respiratory trigger was used in addition to cardiac gating. CE-MRA, with a three-dimensional gradient echo (3D-GRE) T1-weighted sequence, was performed in all patients within the same session. Maximum intensity projection (MIP) image quality, number of renal arteries, and the presence of stenosis were assessed by two observers (independently for NC-MRA and together for CE-MRA). The agreement between NC-MRA and CE-MRA as well as the inter-observer reproducibility were calculated with Bland-Altman plots. Results: MIP image quality was considered better for NC-MRA. NC-MRA identified 143 of 144 (99.3%) arteries detected by CE-MRA (an accessory artery was not identified). Fourteen stenoses were detected by CE-MRA (11 atherosclerotic, 3 dysplastic) with four of 14 (28.5%) significant stenosis. Bland-Altman plot demonstrated an excellent concordance between NC-MRA and CE-MRA; particularly, the reader A evaluated correctly all investigated arteries, while over-estimation of two stenoses occurred for reader B. Regarding NC-MRA, inter-observer agreement was excellent

  6. Renal Artery Stenting in Patients with a Solitary Functioning Kidney

    International Nuclear Information System (INIS)

    Purpose: To retrospectively evaluate the results of renal artery stenting in patients with renovascular disease and a solitary functioning kidney.Methods: Palmazstents were placed in 16 patients with a solitary functioning kidney,renal artery stenosis, hypertension and renal failure. Stenoses were evaluated with color Doppler ultrasound, MR angiography and digital subtraction angiography (DSA). Indications for stenting were: recoil after percutaneous transluminal renal angioplasty (PTRA) (63%),arterial dissection after PTRA (13%) and primary stenting (25%).Immediate results were evaluated by DSA. On follow-up (6-36 months),patients underwent periodical evaluation of clinical conditions (blood pressure and serum creatinine level) and stent patency, by means of color Doppler ultrasound.Results: Stent placement was successful in all patients (100%). Cumulative primary patency rate was: 100% at 1 day, 93.75% at 6 months, 81.25% at 12 months and 75% at 24 months. A significant reduction in diastolic blood pressure occurred (mean ± SD 104 ± 6 vs 92 ± 3;p 0.05).Conclusion: Renal artery stenting, both after PTRA and as primary stenting, represents a safe procedure, able to preserve renal function in patients with a solitary functioning kidney

  7. Nursing experience in clinical endovascular treatment for renal artery aneurysms

    International Nuclear Information System (INIS)

    Objective: To discuss the standardized clinical nursing measures for patients receiving endovascular treatment of renal artery aneurysms. Methods: The clinical data of 9 patients with renal artery aneurysm, who were admitted to authors' hospital during the period from Jan. 2010 to Aug. 2011 and received endovascular treatment, were retrospectively analyzed. The related nursing points as well as the received endovascular. Results: A total of 9 cases with renal artery aneurysm were treated nursing measures were summarized. Results: A total of 9 cases with renal artery aneurysm were with interventional management, including embolization (n = 6), stent implantation (n = 2) and stent implantation together with coil embolization (n = 1). The mean hospitalization time was (10±2) days. Postoperative retention of urine was observed in one patient and postoperative retroperitoneal hemorrhage occurred in another patient. Neither nursing-related nor operation-related complications occurred. Conclusion: Standardized perioperative nursing care for patients with renal artery aneurysm can surely help enhance the patient's tolerance to the surgery, and effectively prevent the complications. (authors)

  8. Percutaneous endovascular management of recurrent aneurysm of transplant renal artery anastomosed to internal iliac artery

    OpenAIRE

    Hegde, Umapati N.; Rajapurkar, Mohan M; Gang, Sishir D.; Lele, Suhas S.

    2008-01-01

    Aneurysm formation constitutes 0.5 to 1% of all vascular complications in transplant patients. Aneurysms may result from infection, injury during procurement or preservation, faulty suture technique or trauma. Transplant renal artery aneurysm presents with hypertension, graft dysfunction and bleeding. We report a case of percutaneous covered stent-graft for recurrent aneurysm with stenosis of transplant renal artery. To our knowledge this is the first report of successful treatment of transpl...

  9. Intravascular optical coherence tomography: differentiation of atherosclerotic plaques and quantification of vessel dimensions in crural arterial specimens

    International Nuclear Information System (INIS)

    Purpose: Intravascular optical coherence tomography (OCT) is a new technique based on infrared light that visualizes the arteries with a resolution of 10-20 μm. Intravascular ultrasound (IVUS) is the current in vivo reference standard and provides a resolution of 100-150 μm. This study compared OCT to IVUS and histopathology with respect to the ability to differentiate atherosclerotic plaques and quantify vascular dimensions in peripheral crural arteries ex vivo. Materials and Methods: 50 segments of atherosclerotic arteries derived from five amputated human lower extremities were examined. The different plaque types (fibrous, high-lipid content, calcified) were assigned by two independent examiners, and the sensitivity and specificity of OCT in comparison with histopathology as well as intra- and interobserver consensus were calculated. A comparison of OCT with IVUS addressed the parameters: luminal area (LA), vascular wall area (VA) and plaque area (PA). Results: When comparing OCT and histopathology with respect to the differentiation of various plaque types, sensitivities of 81% and specificities of 89% for fibrous plaques, of 100% and 93% for lipid-rich plaques and of 80% and 89% for calcified plaques were achieved (overall correlation 83%). Intra- and interobserver consensus was very high (κ=0.86 and κ=0.89, p2 accuracy ±1.8 mm2, r=0.95[p2 accuracy ±2.3 mm2, r=0.94[p2 accuracy ±2.3 mm2, r=0.80[p<0.01]). Conclusion: OCT allows the differentiation of atherosclerotic plaque types in crural arteries with high accuracy compared to histopathology. Quantitative measurements show a high correlation with IVUS, the current reference standard. (orig.)

  10. Thrombolytic therapy in bilateral embolism of renal arteries branches

    Directory of Open Access Journals (Sweden)

    Cassini Marcelo F.

    2003-01-01

    Full Text Available Bilateral renal artery embolism is rare, but it is a significant cause of arterial hypertension and renal failure, and most often is associated with cardiac arrhythmias. We report a case of bilateral renal artery embolism with a satisfactory outcome following use of thrombolytic therapy. A 42 year-old Caucasian man presented a sudden complaint of intense abdominal pain, in mesogastrium and left flank with dorsal irradiation, 3 days after electrical cardioversion due to cardiac arrhythmia. Laboratory tests revealed slight leukocytosis, hematuria, and creatinine of 1.8 mg/dL. Chest radiography was normal and computerized tomography showed an area of massive ischemia in left kidney, and focal ischemia in right kidney and spleen. The patient was then submitted to systemic venous therapy with 1.5 million units of streptokinase, with an excellent outcome.

  11. Automatic plaque characterization and vessel wall segmentation in magnetic resonance images of atherosclerotic carotid arteries

    Science.gov (United States)

    Adame, Isabel M.; van der Geest, Rob J.; Wasserman, Bruce A.; Mohamed, Mona; Reiber, Johan H. C.; Lelieveldt, Boudewijn P. F.

    2004-05-01

    Composition and structure of atherosclerotic plaque is a primary focus of cardiovascular research. In vivo MRI provides a meanse to non-invasively image and assess the morphological features of athersclerotic and normal human carotid arteries. To quantitatively assess the vulnerability and the type of plaque, the contours of the lumen, outer boundary of the vessel wall and plaque components, need to be traced. To achieve this goal, we have developed an automated contou detection technique, which consists of three consecutive steps: firstly, the outer boundary of the vessel wall is detected by means of an ellipse-fitting procedure in order to obtain smoothed shapes; secondly, the lumen is segnented using fuzzy clustering. Thre region to be classified is that within the outer vessel wall boundary obtained from the previous step; finally, for plaque detection we follow the same approach as for lumen segmentation: fuzzy clustering. However, plaque is more difficult to segment, as the pixel gray value can differ considerably from one region to another, even when it corresponds to the same type of tissue. That makes further processing necessary. All these three steps might be carried out combining information from different sequences (PD-, T2-, T1-weighted images, pre- and post-contrast), to improve the contour detection. The algorithm has been validated in vivo on 58 high-resolution PD and T1 weighted MR images (19 patients). The results demonstrate excellent correspondence between automatic and manual area measurements: lumen (r=0.94), outer (r=0.92), and acceptable for fibrous cap thickness (r=0.76).

  12. Correlation of atherosclerotic changes in peripheral arteries with pathological involvement of aortic arch in coronary bypass patients

    Directory of Open Access Journals (Sweden)

    Eshraghi N

    2010-10-01

    Full Text Available "nBackground: A correlation between coronary artery disease (CAD and atherosclerosis of peripheral arteries and the determination of noninvasive indexes for its existence and extent have been sought by many researchers. Some studies report that the intima-media thickness (IMT of peripheral arteries could play this role. This study evaluated the correlation between the IMTs of common carotid and common femoral arteries and the degree of atherosclerosis in aortic arch and to evaluate the severity of CAD in candidates of coronary artery bypass grafting (CABG."n "nMethods: In a cross-sectional analytic-descriptive study, The severity of CAD, the grade of atherosclerosis of the aortic arch, and the IMTs of the common carotid and common femoral arteries were determined."n "nResults: There was a significant weak positive correlation between the IMT of common carotid artery (ρ = 0.193, p = 0.039 and common femoral artery (ρ = 0.206, p = 0.028 with the number of involved carotid vessels; the mean of these two parameters was not significantly different between the three CAD groups. There was not any significant relation between the IMTs of common carotid and common femoral arteries with the severity of atherosclerosis in the aortic arch too. There was not any significant relation between the presences of atherosclerotic plaque in the common carotid or the common femoral arteries with the severity of CAD. The severe atherosclerosis of the aortic arch was significantly higher in patients with three vessel disease."n "nConclusion: According to our results, the IMTs of common carotid and/or common femoral arteries may increase with the severity of CAD; however, these parameters are not a surrogate for predicting the CAD severity.

  13. Predictive Factors of In-Stent Restenosis in Renal Artery Stenting: A Retrospective Analysis

    International Nuclear Information System (INIS)

    Purpose. To retrospectively evaluate the role of clinical and procedural factors in predicting in-stent restenosis in patients with renovascular disease treated by renal artery stenting. Methods. From 1995 to 2002, 147 patients underwent renal artery stenting for the treatment of significant ostial atherosclerotic stenosis. Patients underwent strict clinical and color-coded duplex ultrasound follow-up. Ninety-nine patients (111 stents), with over 6 months of continuous follow-up (mean 22±12 months, range 6-60 months), were selected and classified according to the presence (group A, 30 patients, 32 lesions) or absence (group B, 69 patients, 79 lesions) of significant in-stent restenosis. A statistical analysis was performed to identify possible preprocedural and procedural predictors of restenosis considering the following data: sex, age, smoking habit, diabetes mellitus, hypertension, serum creatinine, cholesterol and triglyceride levels, renal artery stenosis grade, and stent type, length and diameter. Results. Comparing group A and B patients (χ2 test), a statistically significant relation was demonstrated between stent diameter and length and restenosis: the risk of in-stent restenosis decreased when the stent was ≥6 mm in diameter and between 15 and 20 mm in length. This finding was confirmed by multiple logistic regression analysis. Stent diameter and length were proved to be significantly related to in-stent restenosis also when evaluating only patients treated by Palmaz stent (71 stents). Conclusion. Although it is based on a retrospective analysis, the present study confirms the importance of correct stent selection in increasing long-term patency, using stents of at least 6 mm in diameter and with a length of approximately 15-20 mm

  14. Severe hypertension due to renal polar artery stenosis in an adolescent treated with coil embolization

    Energy Technology Data Exchange (ETDEWEB)

    Docx, Martine K. [Koningin Paola Kinderziekenhuis, Department of Paediatrics, Chronic Diseases and Hypertension, Antwerp (Belgium); Vandenberghe, Philippe [Koningin Paola Kinderziekenhuis, Department of Paediatric Cardiology, Antwerp (Belgium); Maleux, Geert [University Hospitals Leuven, Department of Radiology, Leuven (Belgium); Gewillig, Marc [University Hospitals Leuven, Department of Paediatric Cardiology, Leuven (Belgium); Mertens, Luc [Hospital for Sick Children, Paediatric Cardiology, Toronto (Canada)

    2009-11-15

    A 12-year-old boy presented with severe arterial hypertension due to a severe subsegmental renal artery stenosis. Treatment consisted of selective embolization of the stenosed polar artery, which resulted in near normalization of the arterial pressures. Renal artery stenosis should always be considered, even in young adolescents, as a cause for arterial hypertension. Only selective angiography was able to demonstrate the subsegmental artery stenosis in this patient. (orig.)

  15. Effects of Mechanical Properties and Atherosclerotic Artery Size on Biomechanical Plaque Disruption - Mouse versus Human

    OpenAIRE

    Riou, Laurent M.; Broisat, Alexis; Ghezzi, Catherine; Finet, Gérard; Rioufol, Gilles; Gharib, Ahmed M.; Pettigrew, Roderic I.; Ohayon, Jacques

    2014-01-01

    Mouse models of atherosclerosis are extensively being used to study the mechanisms of atherosclerotic plaque development and the results are frequently extrapolated to humans. However, major differences have been described between murine and human atherosclerotic lesions and the determination of similarities and differences between these species has been largely addressed recently. This study takes over and extends previous studies performed by our group and related to the biomechanical chara...

  16. Magnetic characterization of human blood in the atherosclerotic process in coronary arteries

    Energy Technology Data Exchange (ETDEWEB)

    Janus, B. [Institute of Environmental Engineering PAS, ul. SkLodowskiej-Curie 34, 41-819 Zabrze (Poland); Bucko, M.S., E-mail: michal.bucko@helsinki.f [Institute of Environmental Engineering PAS, ul. SkLodowskiej-Curie 34, 41-819 Zabrze (Poland); Division of Geophysics and Astronomy, P.O. Box 64, Gustaf Haellstroemin katu 2, 00014 University of Helsinki (Finland); Chrobak, A. [University of Silesia, Institute of Physics, ul. Uniwersytecka 4, 40-007 Katowice (Poland); Wasilewski, J. [3rd Chair and Clinical Ward of Cardiology, Medical University of Silesia, Katowice, Silesian Centre of Heart Diseases, ul. Szpitalna 2, 41-800 Zabrze (Poland); Zych, M. [Department of Pharmacognosy and Phytochemistry, Medical University of Silesia, ul. Jagiellonska 4, 41-200 Sosnowiec (Poland)

    2011-03-15

    In the last decades there has been an increasing interest in biomagnetism-a field of biophysics concerned with the magnetic properties of living organisms. Biomagnetism focuses on the measurement of magnetic properties of biological samples in the clinical environment. Progress in this field can provide new data for the understanding of the pathomechanism of atherosclerosis and support the diagnostic options for the evaluation and treatment of atherothrombotic complications. Lyophilized human blood samples from patients with atherosclerotic lesions (calcium scoring (CS) CS>0) and without atherosclerotic lesions (CS=0) were magnetically investigated. Magnetic measurements (performed in room and low temperature) indicated significant magnetic differences between these two groups of patients. Atherosclerotic blood samples are characterized by higher concentration of ferrimagnetic particles (magnetite and/or maghemite) and significant changes in the superparamagnetic behaviour. This research presents that magnetometry, in combination with medical research can lead to a better understanding of iron physiology in the atherosclerotic process. - Research Highlights: {yields}Blood samples are characterized by higher concentration of ferrimagnetic particles. {yields}Atherosclerotic blood samples consist of larger superparamagnetic clusters. {yields}Superparamagnetic particles in pathological samples are considered to be magnetite. {yields}The formation of ferrimagnetic particles is favoured in the atherosclerotic patients. {yields}Magnetite may play a role in the progression of atherosclerosis.

  17. Follow-up of combined intervention for patients with both renal and cerebral artery stenosis

    Institute of Scientific and Technical Information of China (English)

    BIAN Xiao-xi; SUN Yu-heng

    2006-01-01

    @@ Renal artery stenosis (RAS) is a frequently overlooked clinical entity that can cause uncontrolled hypertension and lead to a progressive deterioration of renal function.1 We observed 20 patients with RAS complicated with cerebral artery stenosis (CAS), who underwent cerebral and renal artery angiography and combined intervening treatment. Clinical follow-up was performed for more than 3 years.

  18. Renal Artery Stenosis Evaluated with 3D-Gd-Magnetic Resonance Angiography Using Transstenotic Pressure Gradient as the Standard of Reference. A Multireader Study

    International Nuclear Information System (INIS)

    Purpose: To evaluate 3D-Gd-magnetic resonance angiography (MRA) in detecting hemodynamically significant renal artery stenosis (RAS). Material and Methods: Thirty patients evaluated for atherosclerotic RAS by MRA and digital subtraction angiography (DSA) were retrospectively included. Standard of reference for hemodynamically significant RAS was a transstenotic gradient of 15 mmHg. DSA visualized 60 main renal arteries and 9 accessory arteries. Pressure gradient measurement (PGM) was available from 61 arteries. Three radiologists evaluated all examinations independently in a blinded fashion. Results: RAS was present in 26 arteries. On MRA, each reader identified 4 of 9 accessory renal arteries, a detection rate of 44%. The three readers correctly classified 22/25/22 of the 26 vessels with a significant gradient as >60% RAS and 31/25/32 of the 35 with a significant gradient as <60% RAS on MRA. Interobserver agreement was substantial. MRA image quality was adequate for RAS evaluations in all patients. ROC curves indicated that MRA is an adequate method for evaluating RAS. When screening for RAS, a 50% diameter reduction cut-off is better than 60%. RAS with 40-80% diameter reductions accounted for 65% of discrepancies. Conclusion: MRA is an adequate method for evaluating RAS limited mainly by poor detection rate for accessory renal arteries

  19. Renal artery aneurysm in a hypertensive child treated by percutaneous coil embolization

    International Nuclear Information System (INIS)

    A 16-year-old boy was admitted to our hospital with uncontrolled hypertension. A left renal artery aneurysm was detected on colour Doppler US and CT. Renal arteriography demonstrated the aneurysm and focal renal parenchymal areas of decreased perfusion. The renal artery aneurysm was successfully treated by transcatheter coil embolization. (orig.)

  20. The pulsatility index and the resistive index in renal arteries in patients with hypertension and chronic renal failure

    DEFF Research Database (Denmark)

    Petersen, L J; Petersen, J R; Ladefoged, S D;

    1995-01-01

    The pulsatility index (PI) and the resistive index (RI) are used as pulsed-wave Doppler measurement of downstream renal artery resistance. Little information is available on their value in chronic renal failure and their correlation to parameters of renal function and haemodynamics. The aim was to...... compare PI and RI of renal arteries in healthy volunteers and in patients with hypertension and chronic renal failure, and furthermore to study the correlation of these indices to measurements of renal haemodynamics and function by standard methods in patients with renal failure and hypertension....

  1. Darbepoetin alpha reduces oxidative stress and chronic inflammation in atherosclerotic lesions of apo E deficient mice in experimental renal failure.

    Directory of Open Access Journals (Sweden)

    Nicole Arend

    Full Text Available BACKGROUND: Cardiovascular morbidity and mortality is very important in patients with chronic renal failure. This occurs even in mild impairment of renal function and may be related to oxidative stress and chronic inflammation. The nephrectomized apo E knockout mouse is an accepted model for evaluating atherosclerosis in renal dysfunction. Erythropoietin derivates showed anti-oxidative and anti-inflammatory effects. Therefore, this study evaluates the effects of Darbepoetin on markers of oxidative stress and chronic inflammation in atherosclerotic lesions in apo E knockout mice with renal dysfunction. METHODS: Apo E knockout mice underwent unilateral (Unx, n = 20 or subtotal (Snx, n = 26 nephrectomy or sham operation (Sham, n = 16. Mice of each group were either treated with Darbepoetin or saline solution, a part of Snx mice received a tenfold higher dose of Darbepoetin. The aortic plaques were measured and morphologically characterized. Additional immunhistochemical analyses were performed on tissue samples taken from the heart and the aorta. RESULTS: Both Unx and Snx mice showed increased expression of markers of oxidative stress and chronic inflammation. While aortic plaque size was not different, Snx mice showed advanced plaque stages when compared to Unx mice. Darbepoetin treatment elevated hematocrit and lowered Nitrotyrosin as one marker of oxidative stress, inflammation in heart and aorta, plaque stage and in the high dose even plaque cholesterol content. In contrast, there was no influence of Darbepoetin on aortic plaque size; high dose Darbepoetin treatment resulted in elevated renal serum parameters. CONCLUSION: Darbepoetin showed some protective cardiovascular effects irrespective of renal function, i.e. it improved plaque structure and reduced some signs of oxidative stress and chronic inflammation without affecting plaque size. Nevertheless, the dose dependent adverse effects must be considered as high Darbepoetin treatment

  2. Ankle-brachial index as indicator of chronic arterial insufficiency of the lower extremities and renal artery stenosis CT/DS angiography

    International Nuclear Information System (INIS)

    Full text: The aim is to validate the measurements of ankle -brachial index (ABI), as part of routine examination algorithm in conducting CTA/DSA of the extremities in patients suffering from PAD. Correlations between ABI values and renal artery stenosis. The present study includes 200 patients (138 men and 62 women, aged between 60 and 75 years). 130 of them were examined by a computer- tomography angiography - 95 men and 32 women. 70 patients were examined by digital subtraction angiography - 50 men and 20 women. Measurements of ankle-brachial index (ABI) were performed on all patients by measuring the systolic blood pressure on both brachial arteries and determine the peak pressure in both aa. dorsalis pedis. Statistical data processing. There are no patients in the study with ABI values above 0.7 that have established renal artery stenosis. All patients with severe atherosclerotic changes have values of the ABI below 0.7, and those with the most severe changes below 0.5. This fully corresponds to global data showing that values below 0.9 ABI show mild engagement, below 0.7 average, and below 0.5 severe involvement. According to the results of this survey sensitivity of ABI for renal arteries below 0.7 equals 100% and its specificity = 67.5%. For values of ABI below 0.5: Sensitivity =100%; Specificity = 83.85%. By determining ABI values both symptomatic and asymptomatic form of a PAD can be diagnosed. the method is fast, non-invasive, inexpensive and applicable everywhere. No special preparation of the patient is needed. The method can be used not only to assess the degree of commitment of the vessels of the lower limbs, but also as an indicator for the state of renal arteries in those patients

  3. Angiographic estimation of atherosclerotic disease burden in a coronary artery fed by collaterals: a potential pitfall in decision for revascularization

    Directory of Open Access Journals (Sweden)

    Grigorios Tsigkas

    2011-03-01

    Full Text Available Grigorios Tsigkas, Panagiota Mylona, Periklis Davlouros, Dimitrios AlexopoulosCardiology Department, University Hospital of Patras, Patras, GreeceAbstract: Despite the remarkable advances in revascularization strategies made during the last decade, a significant proportion of patients are excluded from either percutaneous coronary intervention or coronary artery bypass grafting because of unsuitable coronary anatomy. Diffuse severe coronary artery disease, small vessel caliber, chronic total occlusions, or extremely calcified vessels are frequent reasons for deferring revascularization with either percutaneous coronary intervention or coronary artery bypass grafting. We present a case concerning a middle-aged asymptomatic patient who was treated successfully with percutaneous coronary intervention due to a chronic total occlusion lesion of the left anterior descending artery. Coronary angiography is an inadequate method for the estimation of the burden of atherosclerotic disease in an artery fed by collaterals. Assessment of any residual antegrade flow, and ipsilateral and contralateral collateral filling of the segments distal to the occlusion with invasive or noninvasive techniques, could affect the appropriate decision-making by physicians.Keywords: collaterals, percutaneous coronary intervention, coronary artery bypass grafting, ischemia, revascularization, chronic total occlusion 

  4. Renal arterial aneurysm--an incidental finding at autopsy.

    Directory of Open Access Journals (Sweden)

    Vaideeswar P

    1998-01-01

    Full Text Available Herein we describe a rare case of saccular renal artery aneurysm seen as an incidental autopsy finding in an elderly, hypertensive female. The aneurysm was seen as a small exophytic mass with calcified wall and lumen occluded by recanalized thrombus.

  5. Impact of diabetes mellitus on outcome of renal artery stenting

    International Nuclear Information System (INIS)

    Objective: To investigate the impact of diabetes mellitus on outcome of renal artery stenting. Methods: 85 consecutive cases of renal artery stenosis received renal angioplasty were retrospectively analyzed. 25 patients with related history were selected into diabetic group (DM), and 60 patients without diabetics into control group(NDM). Pre- and post- procedure serum creatinine and blood pressure between the 2 groups were collected and analyzed. Results: The average serum creatinine pre-intervention and post-intervention were(132.24 ± 33.71) μmol/L, (126.32 ± 29.65) μmol/L for DM group, and(125.02 ± 48.13) μmol/L, (118.31 ± 39.58) μmol/L for NDM group respectively with no significant statistical difference (P > 0.05). The blood pressure was controlled satisfactorily for both groups after the procedure, with statistical significance (P<0.05), but no difference between the two groups. Conclusions: The procedure with renal artery stenting is effective to maintain renal function and control hypertension, showing equal efficiency for both DM and NDM patients. (authors)

  6. Echobiometrics kidney and renal artery triplex doppler of canine fetuses

    Directory of Open Access Journals (Sweden)

    M.A.R. Feliciano

    2014-04-01

    Full Text Available The aim of this study was to assess the sogographic parameters and biometry of canine fetal kidneys using the B mode, and to determinate the vascular index of the fetal renal arteries using the Doppler Triplex. Twenty four Shi-tzu and Pug, weighting between 4 and 10kg, aging between 4 and 6 years old were evaluated. The B mode, the fetal renal echobiometry and regularity of the renal surface, echotexture and cortex:medular ratio were evaluated during the 5th, 6th, 7th and 8th weeks of pregnancy. At the same time point of the B mode evaluation, the Doppler Triplex was carried out to assess the sistolic peak velocity (SPV, end diastolic velocity (EDV, vascular resistive (RI and pulsatility index (PI. B mode revealed no fetal renal abnormalities and echobiometry showed important measurements during fetal development (P0.05. B mode and Doppler Triplex were important tools for the assessment of fetal renal development, using echobiometry and renal arterial index in canie fetuses.

  7. Urgent revascularisation can preserve renal function in a patient with severe hypertension because of renal artery stenosis

    DEFF Research Database (Denmark)

    Jensen, Janni Majgaard; Pedersen, Erling B

    2013-01-01

    We present a case of a 61-year-old woman with renal artery stenosis in a solitary functional kidney. The patient was admitted with recurrent severe hypertension, flash pulmonary oedema and acute kidney failure. She underwent surgical intervention, after which blood pressure and plasma creatinine...... level remained normal during a 11-year follow-up. Renal artery stenosis may have a serious course with flash pulmonary oedema and dialysis-dependent renal failure. Urgent revascularisation may be the only option to avoid pulmonary oedema and preserve renal function in patients with renal artery stenosis....

  8. Lipocalin (LCN 2 Mediates Pro-Atherosclerotic Processes and Is Elevated in Patients with Coronary Artery Disease.

    Directory of Open Access Journals (Sweden)

    Raghav Oberoi

    Full Text Available Lipocalin (LCN 2 is associated with multiple acute and chronic inflammatory diseases but the underlying molecular and cellular mechanisms remain unclear. Here, we investigated whether LCN2 is released from macrophages and contributes to pro-atherosclerotic processes and whether LCN2 plasma levels are associated with the severity of coronary artery disease progression in humans.In an autocrine-paracrine loop, tumor necrosis factor (TNF-α promoted the release of LCN2 from murine bone-marrow derived macrophages (BMDM and vice versa. Moreover, LCN2 stimulation of BMDM led to up-regulation of M1 macrophage markers. In addition, enhanced migration of monocytic J774A.1 cells towards LCN2 was observed. Furthermore, LCN2 increased the expression of the scavenger receptors Lectin-like oxidized low-density lipoprotein receptor-1 (LOX-1 as well as scavenger receptor class A-1 (SRA-1 and induced the conversion of macrophages to foam cells. In atherosclerotic lesions of low density lipoprotein receptor-deficient (ldlr-/- mice fed a high fat, high cholesterol diet, LCN2 was found to be co-localized with macrophages in the shoulder region of the atherosclerotic plaque. In addition, LCN2 plasma levels were significantly increased in plasma samples of these mice. Finally, LCN2 plasma levels correlated with the severity of coronary artery disease (CAD in patients as determined by coronary angiography.Here we demonstrated that LCN2 plays a pivotal role in processes involved in atherogenesis by promoting polarization and migration of monocytic cells and development of macrophages towards foam cells. Moreover, LCN2 may be used as a prognostic marker to determine the status of CAD progression.

  9. Renal Arterial Network Structure by Computed Tomography, and Nephron-Arterial Interactions

    DEFF Research Database (Denmark)

    2015-01-01

    , with afferent arterioles originating from all arterial structures, including arcuate arteries. The modeling component has 2 novel features: a probability based vascular tree based on the data from the CT images, and a network of arteries supplying several simple whole nephron models coupled electrotonically......Our goal is to predict interactions that develop among nephrons and between nephrons and the arterial network that supports them. We have developed a computationally simple but physiologically-based mathematical model of the kidney vascular tree to study renal autoregulation in ensembles....... The network model predicts dynamical aspects of vascular pressure drops and nephron self-sustained cooperative dynamics....

  10. A direct anatomical study of additional renal arteries in a Colombian mestizo population.

    Science.gov (United States)

    Saldarriaga, B; Pérez, A F; Ballesteros, L E

    2008-05-01

    Traditional anatomy describes each kidney as receiving irrigation from a single renal artery. However, current literature reports great variability in renal blood supply, the number of renal arteries mentioned being the most frequently found variation. Such variation has great implications when surgery is indicated, such as in renal transplants, uroradiological procedures, renovascular hypertension, renal trauma and hydronephrosis. This article pretends to determine the frequency of additional renal arteries and their morphological expression in Colombian population in a cross-sectional study. A total of 196 of renal blocks were analysed from autopsies carried out in the Bucaramanga Institute of Forensic Medicine, Colombia; these renal blocks were processed by the injection- corrosion technique. The average age of the people being studied was 33.8 +/- 15.6 years; 85.4% of them were male and the rest female. An additional renal artery was found in 22.3% of the whole population and two additional ones were found in 2.6% of the same sample. The additional renal artery was most frequently found on the left side. The additional artery arose from the aorta's lateral aspect (52.4%); these additional arteries usually entered the renal parenchyma through the hilum. No difference was established according to gender. Nearly a third of the Colombian population presents one additional renal artery and about 3% of the same population presents two additional renal arteries. Most of them reached the kidney through its hilar region. PMID:18521812

  11. Renal Artery Embolization of Perirenal Hematoma in Hemorrhagic Fever with Renal Syndrome: A Case Report

    International Nuclear Information System (INIS)

    Hemorrhagic fever with renal syndrome (HFRS) is an acute viral disease characterized by fever, hemorrhage and renal failure. Among the various hemorrhagic complications of HFRS, spontaneous rupture of the kidney and perirenal hematoma are very rare findings. We report here on a case of HFRS complicated by massive perirenal hematoma, and this was treated with transcatheter arterial embolization. Hemorrhagic fever with renal syndrome (HFRS) is an acute infectious disease caused by hantavirus. HFRS is clinically characterized by fever, renal failure and hemorrhage in organs such as lung, kidney, spleen and the pituitary gland. Renal medullary hemorrhage is a well-known complication in the kidney, but spontaneous rupture of the kidney and perirenal hematoma in HFRS is rare, and patients showing continuous bleeding and massive perirenal hematoma have often been surgically treated. We report here on a case of HFRS complicated by massive perirenal hematoma, and the patient was treated with transcatheter arterial embolization. In summary, spontaneous rupture of the kidney and perirenal hematoma is a rare complication of HFRS. We report here on a case of HFRS that caused massive perirenal hematoma, and this was treated with superselective renal artery embolization

  12. Renal Artery Embolization of Perirenal Hematoma in Hemorrhagic Fever with Renal Syndrome: A Case Report

    Energy Technology Data Exchange (ETDEWEB)

    Choi, Hee Seok; Lee, Yong Seok; Lim, Ji Hyon; Kim, Kyung Soo; Yoon, Yup [Dongguk University College of Medicine, Goyang (Korea, Republic of); Hwang, Jae Cheol [Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan (Korea, Republic of)

    2007-08-15

    Hemorrhagic fever with renal syndrome (HFRS) is an acute viral disease characterized by fever, hemorrhage and renal failure. Among the various hemorrhagic complications of HFRS, spontaneous rupture of the kidney and perirenal hematoma are very rare findings. We report here on a case of HFRS complicated by massive perirenal hematoma, and this was treated with transcatheter arterial embolization. Hemorrhagic fever with renal syndrome (HFRS) is an acute infectious disease caused by hantavirus. HFRS is clinically characterized by fever, renal failure and hemorrhage in organs such as lung, kidney, spleen and the pituitary gland. Renal medullary hemorrhage is a well-known complication in the kidney, but spontaneous rupture of the kidney and perirenal hematoma in HFRS is rare, and patients showing continuous bleeding and massive perirenal hematoma have often been surgically treated. We report here on a case of HFRS complicated by massive perirenal hematoma, and the patient was treated with transcatheter arterial embolization. In summary, spontaneous rupture of the kidney and perirenal hematoma is a rare complication of HFRS. We report here on a case of HFRS that caused massive perirenal hematoma, and this was treated with superselective renal artery embolization.

  13. [Hemodynamic features assessment in submental and facial arteries in patients with early atherosclerotic disease of brachycephalic arteries].

    Science.gov (United States)

    Nadtochiĭ, A G; Grudianov, A I; Avraamova, T V

    2014-01-01

    By ultrasonicduplex scanning nature estimated haemodynamics in the arteriessubmentalis and facial of patients with early signs of atherosclerotic changes in the brakhiotsefalarteries and periodontal pathology of different stages - for perfection of prophylaxis of periodontal diseases by the means of investigation of prophylaxis vascular diseases. It was established, that influence of risk factors is more important than the age of patients. PMID:25588335

  14. Non-stenotic intracranial arteries have atherosclerotic changes in acute ischemic stroke patients: a 3T MRI study

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Woo Jin; Choi, Hyun Seok; Jang, Jinhee; Sung, Jinkyeong; Jung, So-Lyung; Ahn, Kook-Jin; Kim, Bum-soo [The Catholic University of Korea, Department of Radiology, Seoul St. Mary' s Hospital, College of Medicine, Seoul (Korea, Republic of); Kim, Tae-Won; Koo, Jaseong [The Catholic University of Korea, Department of Neurology, College of Medicine, Seoul (Korea, Republic of); Shin, Yong Sam [The Catholic University of Korea, Department of Neurosurgery, College of Medicine, Seoul (Korea, Republic of)

    2015-10-15

    The aim of this study is to evaluate the degree of atherosclerotic changes in intracranial arteries by assessing arterial wall thickness using T1-weighted 3D-turbo spin echo (3D-TSE) and time-of-flight MR angiography (TOF-MRA) in patients with acute ischemic stroke as compared with unaffected controls. Thirty-three patients with acute ischemic stroke and 36 control patients were analyzed. Acute ischemic stroke patients were divided according to TOAST classification. At both distal internal carotid arteries and basilar artery without stenosis, TOF-MRA was used to select non-stenotic portion of assessed arteries. 3D-TSE was used to measure the area including the lumen and wall (Area{sub Outer}) and luminal area (Area{sub Inner}). The area of the vessel wall (Area{sub VW}) of assessed intracranial arteries and the ratio index (RI) of each patient were determined. Area{sub Inner}, Area{sub Outer}, Area{sub VW}, and RI showed good inter-observer reliability and excellent intra-observer reliability. Area{sub Inner} did not significantly differ between stroke patients and controls (P = 0.619). However, Area{sub Outer}, Area{sub VW}, and RI were significantly larger in stroke patients (P < 0.001). The correlation coefficient between Area{sub Inner} and Area{sub Outer} was higher in the controls (r = 0.918) than in large vessel disease patients (r = 0.778). RI of large vessel disease patients was significantly higher than that of normal control, small vessel disease, and cardioembolic groups. In patients with acute ischemic stroke, wall thickening and positive remodeling are evident in non-stenotic intracranial arteries. This change is more definite in stroke subtype that is related to atherosclerosis than that in other subtypes which are not. (orig.)

  15. Non-stenotic intracranial arteries have atherosclerotic changes in acute ischemic stroke patients: a 3T MRI study

    International Nuclear Information System (INIS)

    The aim of this study is to evaluate the degree of atherosclerotic changes in intracranial arteries by assessing arterial wall thickness using T1-weighted 3D-turbo spin echo (3D-TSE) and time-of-flight MR angiography (TOF-MRA) in patients with acute ischemic stroke as compared with unaffected controls. Thirty-three patients with acute ischemic stroke and 36 control patients were analyzed. Acute ischemic stroke patients were divided according to TOAST classification. At both distal internal carotid arteries and basilar artery without stenosis, TOF-MRA was used to select non-stenotic portion of assessed arteries. 3D-TSE was used to measure the area including the lumen and wall (AreaOuter) and luminal area (AreaInner). The area of the vessel wall (AreaVW) of assessed intracranial arteries and the ratio index (RI) of each patient were determined. AreaInner, AreaOuter, AreaVW, and RI showed good inter-observer reliability and excellent intra-observer reliability. AreaInner did not significantly differ between stroke patients and controls (P = 0.619). However, AreaOuter, AreaVW, and RI were significantly larger in stroke patients (P < 0.001). The correlation coefficient between AreaInner and AreaOuter was higher in the controls (r = 0.918) than in large vessel disease patients (r = 0.778). RI of large vessel disease patients was significantly higher than that of normal control, small vessel disease, and cardioembolic groups. In patients with acute ischemic stroke, wall thickening and positive remodeling are evident in non-stenotic intracranial arteries. This change is more definite in stroke subtype that is related to atherosclerosis than that in other subtypes which are not. (orig.)

  16. Spontaneous renal artery thrombosis and common iliac artery dissection in a previously healthy young adult.

    Science.gov (United States)

    Penn, D Eli; Gist, Amber; Axon, R Neal

    2008-12-01

    A previously healthy 20-year-old male with a history of easy bruising presented to the emergency department complaining of intermittent left lower quadrant abdominal pain for one week. He was diagnosed with vascular (type IV) Ehlers-Danlos syndrome (EDS) and attendant defects in type III collagen leading to spontaneous left renal artery thrombosis and common iliac artery dissection. Treatment was conservative. The types of EDS and their general management are discussed. PMID:19005424

  17. Endovascular Repair of Renal Artery Anastomotic Pseudoaneurysm Following Living Donor Kidney Transplant.

    Science.gov (United States)

    Patil, Vivek V; Roytman, Michelle; Ames, Scott; Beckerman, William; Lookstein, Robert A

    2015-12-01

    Renal artery anastomotic pseudoaneurysms, an uncommon complication of transplantation, may result in aneurysm rupture and loss of allograft. We report the case of 50-year-old female with back pain 3 weeks post renal transplantation. CT scan revealed transplant renal artery anastomotic pseudoaneurysm arising from anastomosis of two renal arteries joined together to form a single renal artery that was joined to the aorta. Successful endovascular treatment was achieved with covered stents, resulting in preserved renal function. Follow-up ultrasound at one-day post procedure and CT at 2 months revealed satisfactory renal perfusion with no pseudoaneurysm. Endovascular treatment of transplant renal artery pseudoaneurysms with covered stent and ostial flare balloon technology may be preferred in patients with extensive prior pelvic surgery, as illustrated in this case. PMID:26037091

  18. The pulsatility index and the resistive index in renal arteries. Associations with long-term progression in chronic renal failure

    DEFF Research Database (Denmark)

    Petersen, L J; Petersen, J R; Talleruphuus, U;

    1997-01-01

    The pulsatility index (PI) and the resistive index (RI) are used as pulsed-wave Doppler measurements of downstream renal artery resistance. PI and RI have been found to correlate with renal vascular resistance, filtration fraction and effective renal plasma flow in chronic renal failure. The aim of...... the present study was to evaluate the potential relationship between these indices and the rate of decline in renal function, as reflected by changes in different parameters of renal function in patients with chronic renal failure....

  19. Aneurisma da Artéria Renal: caso clínico Renal Artery Aneurysm

    Directory of Open Access Journals (Sweden)

    Joana Moreira

    2011-12-01

    Full Text Available Apresenta-se o caso clínico de um doente com volumoso aneurisma da artéria renal esquerda. Do sexo masculino, de 22 anos de idade, com lombalgia à esquerda com algumas semanas de evolução. Recorreu ao médico assistente que solicitou estudo imagiológico por ecografia abdominal. Detectada imagem sugestiva de aneurisma da aorta abdominal. Este achado motivou a transferência para o nosso Hospital onde foi admitido consciente e orientado, hemodinamicamente estável, apresentando uma massa pulsátil epigástrica, com frémito e sopro sistólico à auscultação. Angio-TC revelou um aneurisma da artéria renal esquerda com 16 cm de diâmetro. Dada a estabilidade clínica e topografia lesional optou-se por tentar embolizar, sem sucesso, o tronco da artéria renal esquerda antes da abordagem cirúrgica. O doente foi então submetido a Nefrectomia total esquerda por via toraco-abdominal. Pós-operatório sem complicações, locais ou sistémicas. Alta ao 8ºdia, mantendo boa função renal e com níveis normais de hemoglobina. Diagnóstico de aneurisma da artéria renal confirmado por estudo anátomo-patológico da peça operatória.One case of a large left renal artery aneurysm in a young patient 22 years old is presented. He appealed to his assistant physician a few weeks after development of left back pain. Abdominal ultrasound imaging study has been requested. Suggestive abdominal aortic aneurysm was detected. This finding led to the transfer to our hospital where he was admitted conscious and hemodynamically stable. A pulsatile epigastric mass with a systolic murmur on auscultation and thrill were detected. Angio-CT scan revealed a left renal artery aneurysm, 16 cm in diameter. Given the clinical stability and lesional topography we decide a previous embolization of left renal artery, unsuccessfully. The patient underwent then left total nephrectomy, through thoraco-abdominal incision. No local or systemic complications in the postoperative

  20. Value of downstream circulation in renal artery stenosis with arterial hypertension: comparison between color Doppler flow and digital renal angiography in 123 patients

    International Nuclear Information System (INIS)

    Digital renal angiography and color Doppler flow were compared for diagnosis of renal artery stenosis in 123 hypertensive patients with a prevalence of renal artery stenosis ≥75% of 21 %. Only color Doppler flow signs found downstream from the stenosis could be quantified. A rising time (RT) >0.07 s was the best marker for renal artery stenosis ≥ 75 % according to a receiver operating characteristic curve with a specificity of 97 %, a sensitivity of 88 %, a positive predictive value of 86 %, a negative predictive value of 98 % and an accuracy of 96 %. Digital renal angiography and color Doppler flow findings for renal artery lesions were classified into 4 degrees with agreement for 86 % of the kidneys. (authors). 13 refs., 5 figs., 8 tabs

  1. Takayasu Arteritis with Bilateral Renal Artery Stenosis and Left Subclavian Artery Stenosis in Pregnancy.

    Science.gov (United States)

    Nalini, Sharma; Santa, Singh Ahanthem

    2015-09-01

    Takayasu arteritis (TA) is a rare, systemic, chronic inflammatory, progressive, idiopathic disease of aorta and its main branches. It causes narrowing, occlusion and aneurysm of arteries. It affects mainly young females in about 80-90% of cases (young female arteritis). TA has adverse effect on pregnancy in the form of abortion, superimposed preeclampsia, IUGR (Intrauterine growth restriction), IUFD (intrauterine fetal death), abruption and CCF (congestive cardiac failure). Careful assessment, treatment of TA complication, regular antenatal followup and multidisciplinary approach involving obstetrician, cardiologist, rheumatologist and anaesthetist improve maternal and fetal outcome. We described here a case of pregnancy with TA with bilateral renal artery stenosis and left subclavian artery stenosis. PMID:26500964

  2. Bone Metabolism and Arterial Stiffness After Renal Transplantation

    Directory of Open Access Journals (Sweden)

    Orsolya Cseprekál

    2014-11-01

    Full Text Available Background/Aims: To assess the relationship between bone and vascular disease and its changes over time after renal transplantation. Metabolic bone disease (MBD is common in chronic kidney disease (CKD and is associated with cardiovascular (CV disease. Following transplantation (Tx, improvement in CV disease has been reported; however, data regarding changes in bone disease remain controversial. Methods: Bone turnover and arterial stiffness (pulse wave velocity (PWV were assessed in 47 Tx patients (38 (3-191 months after Tx. Results: Bone alkaline phosphatase (BALP, osteocalcin (OC and beta-crosslaps were significantly higher in Tx patients, and decreased significantly after one year. There was a negative correlation between BALP, OC and steroid administered (r=-0.35;r=-0.36 respectively. PWV increased in the Tx group (1.15 SD. In patients with a follow up of Conclusions: Increased bone turnover and arterial stiffness are present following kidney transplantation. While bone turnover decreases with time, arterial stiffness correlates initially with bone turnover, after which the influence of cholesterol becomes significant. Non-invasive estimation of bone metabolism and arterial stiffness may help to assess CKD-MBD following renal transplantation.

  3. Urgent stenting for patients with acute stroke due to atherosclerotic occlusive lesions of the cervical internal carotid artery

    International Nuclear Information System (INIS)

    Acute symptomatic occlusion of the cervical internal carotid artery (ICA) can be treated by intravenous administration of tissue plasminogen activator, percutaneous transluminal angioplasty, and carotid endarterectomy. Carotid artery stenting (CAS) is now indicated for cervical ICA stenosis, but the safety and the efficacy of urgent CAS have not been established. We retrospectively reviewed 10 patients treated by urgent CAS for atherosclerotic occlusive lesions of cervical ICA with acute stroke. Five patients had complete occlusions and five had near total occlusions. Five of the 10 patients had intracranial tandem occlusions. Indication for urgent CAS was determined by mismatch of diffusion-weighted and perfusion-weighted magnetic resonance imaging findings. Stents were successfully deployed in all lesions. Three of five patients with concomitant intracranial tandem occlusions were treated by additional intraarterial fibrinolysis after the CAS. Intracranial artery occlusions were completely recanalized in one patient, and partially recanalized in two by fibrinolysis. Hyperperfusion syndrome did not occur in any of the patients. A favorable outcome (modified Rankin Scale ≤1) was obtained in all of the five patients with isolated cervical ICA occlusion and one of the five patients with intracranial tandem occlusions. Urgent CAS is a safe and effective treatment in patients with isolated cervical ICA occlusion. Treatment of intracranial tandem occlusions is an issue that must be resolved. (author)

  4. Can MR Measurement of Renal Artery Flow and Renal Volume Predict the Outcome of Percutaneous Transluminal Renal Angioplasty?

    International Nuclear Information System (INIS)

    Purpose: Predicting therapeutic benefit from percutaneous transluminal renal angioplasty (PTRA) in patients with renal artery stenosis (RAS) remains difficult. This study investigates whether magnetic resonance (MR)-based renal artery flow measurements relative to renal parenchymal volume can predict clinical outcome following PTRA.Methods: The data on 23 patients (13 men, 10 women; age range 47-82 years, mean age 64 years) were analyzed. The indication for treatment was hypertension (n = 18) or renal insufficiency (n = 5). Thirty-four cases of RAS were identified: bilateral disease was manifest in 11 and unilateral disease in 12 patients. The MR imaging protocol included a breath-hold, cardiac-gated cine phase-contrast sequence for renal flow measurement and a fast multiplanar spoiled gradient-echo sequence for renal volume measurement. MR measurements were performed on the day prior to and the day following PTRA. Clinical success was defined as (a) a reduction in diastolic blood pressure > 15% or (b) a reduction in serum creatinine > 20%. Kidneys were categorized as normal volume or low volume. A renal flow index (RFI) was calculated by dividing the renal flow (ml/min) by the renal volume (cm3).Results: Clinical success was observed in 11 patients. Twelve patients did not benefit from angioplasty. Normal kidney volume was seen in 10 of 11 responders and in 8 of 12 nonresponders, resulting in a sensitivity of 91%, specificity of 33%, a positive predictive value (PPV) of 56% and a negative predictive value (NPV) of 80%. A RFI below a threshold of 1.5 ml/min/cm3 predicted successful outcome with 100% sensitivity, 33% specificity, 58% PPV, and 100% NPV. The combination of normal renal volume and a RFI below 1.5 ml/min/cm3 identified PTRA responders with a sensitivity of 91%, a specificity of 67%, a PPV of 71%, and a NPV of 89%. PTRA resulted in a greater increase in renal flow in responders compared with nonresponders (p < 0.001).Conclusion: A combination of cine

  5. Evaluation by multislice computed tomography of atherosclerotic coronary artery plaques in non-culprit, remote coronary arteries of patients with acute coronary syndrome

    International Nuclear Information System (INIS)

    Patients with acute coronary syndrome (ACS) frequently have vulnerable plaques in the remote coronary arteries, suggesting that ACS is part of the pan-coronary process. In the present study the computed tomography (CT) plaque density in non-culprit atherosclerotic coronary artery lesions was evaluated by multi-slice computed tomography (MSCT) in patients with ACS and non-ACS. MSCT was performed in 21 patients with ACS and 53 patients with non-ACS: 16 of the 21 ACS patients (76%) and 30 of the non-ACS 53 patients (57%) had non-calcified plaques in the non-culprit coronary arteries (p=0.18). CT-low-density plaques (CT density <68 Hounsfield units (HU)) were more frequent in the ACS group (13/16 patients, 81%) than in the non-ACS group (13/30 patients, 43%, p=0.03). In addition, the CT density of the non-culprit lesion was significantly lower in patients with ACS than in those with non-ACS (44.1±22.9 and 77.3±33.7 HU, respectively). Patients with ACS more frequently had CT-low-density plaques in the non-culprit, remote arteries than those with non-ACS, which suggests that ACS treatment should focus not only on stabilizing the culprit lesion but also on systemic stabilization of non-culprit lesions. (author)

  6. Concomitant atherosclerotic disease detected by whole-body MR angiography in relation to coronary artery calcification in patients with coronary artery disease

    International Nuclear Information System (INIS)

    Purpose: Patients with coronary artery disease (CAD) show a high prevalence for concomitant atherosclerotic peripheral arterial disease (PAD). On the other hand, PAD seems to be an additional risk factor for cardiac events. We evaluated the correlation between arterial pathologies as found in whole-body MR angiography and coronary artery calcification (CAC) detected by electron beam computed tomography (EBCT) and multislice CT (MSCT). Materials and Methods: Two hundred and twenty-eight patients (161 men; 67 women) with suspicion for CAD/known CAD underwent whole-body contrast-enhanced MR angiography (wb-ce-MRA) and EBCT/MSCT. An atherosclerosis index was calculated for each patient Index = sum n=140wi with wi being the grading of the stenosis of the iten of 40 arteria segments (grade: 0 - no plaque; 1 - plaque - ≤ 50 % stenosis; 2 - > 50 % stenosis - ≤ 90 % stenosis; 3 - > 90 % stenosis - < 100 % stenosis; 4 - occlusion). Correlations between CAC and atherosclerosis index were performed. Results: Wb-ce MRA and CAC correlate only moderately in this population. An atherosclerosis index 8 renders a positive predictive value for a CAC 100 of 63.3 %. Conclusion: An atherosclerosis index as defined in this study does not fully correlate with the extent of CAD as revealed by catheter angiography or EBCT/MSCT, but it might theoretically mirror the increased risk by PAD. It thus might be a promising complementary parameter for the prediction of cardiac events. Future studies need to show its possible additional predictive impact.

  7. Detection of renal arteries with fast spin-echo magnetic resonance imaging

    International Nuclear Information System (INIS)

    With the increasing use of non-invasive imaging with MR and volumetric CT to evaluate renal arteries, the ability to accurately detect the number and state of native renal arteries becomes critical if conventional angiography is to be supplanted in these settings. The present study evaluated the utility of a fast spin-echo (FSE) T2-weighted sequence to detect the number and course of renal arteries and their ostia compared to conventional angiography. Ten patients underwent conventional catheter angiography either for renal artery stenosis evaluation or as potential renal donors. Each patient then had an MR study of the renal arteries and kidneys with FSE MR (TR = 4000 ms, TE = 102 ms, eight- echo train length, 5-mm-thick interleaved 128 phase encodes, superior and inferior saturation pulses, number of excitations (NEX) = 4, on a 1.5-T superconducting magnet. Images were reviewed by two 'blinded' radiologists and renal arteries were counted and their ostia were evaluated. Results were compared with angiography and inter- and intra-observer statistics were calculated. All 10 patients underwent MR successfully, nine for renal artery stenosis (RAS) evaluation and one was a renal donor. A total of 24 renal arteries were imaged in 19 kidneys. Fast spin-echo MR is 95% accurate (95%CI: 88-100%) in detection of renal arteries, with no statistical difference between FSE MR and catheter angiography (McNemar P = 0.0). Inter- and intra-observer statistics demonstrate good-to-excellent agreement in renal artery detection (kappa: 0.63-0.90). In one case of RAS evaluation an incidental adrenal mass was detected as the aetiology of the patient's hypertension. Fast spin-echo MR can be a useful adjunct as part of the imaging for renal arteries with MRI. Copyright (1998) Blackwell Science Pty Ltd

  8. Quantitative Evaluation of the Polarization Characteristics of Coronary Arteries Atherosclerotic Plaques at Different Development Stages

    Directory of Open Access Journals (Sweden)

    E.V. Gubarkova

    2015-12-01

    Full Text Available The aim of the investigation was to develop an approach to quantitative evaluation of polarization properties (birefringence and cross-scattering basing on cross-polarization OCT images (CP OCT in order to characterize the development stages of atherosclerotic plaques and to reveal unstable ones. Materials and Methods. We report on quantitative analysis of CP OCT images of the seven development stages of atherosclerotic plaques ex vivo. Integral depolarization factor (IDF and effective birefringence coefficient (Δn were proposed as parameters for quantitative characterization of the CP OCT images. Results. Calculation of the IDF and Δn in the local region of interest (intima/fibrous cap showed a statistically relevant difference between stable (stage IV and unstable (stage Va plaques (0.46±0.21 against 0.09±0.04 for IDF and (0.47±0.10·10–3 against (0.25±0.07·10–3 for Δn; (p<0.05. It was found that Δn value in the range (0.22–0.29·10–3 (within the limits of two standard deviations indicates the presence of only a small amount of highly organized collagen in the fibrous cap of an unstable plaque which can indicate its tendency to rupture. We believe that these changes are connected with the prevalence of disorganized fibers during the inflammatory process in the fibrous cap of an unstable plaque, and to the presence of clusters of foam cells and inflammatory cells between them. Conclusion. The proposed approach to the quantitative evaluation of CP OCT images (calculation of IDF and building Δn maps allows to assess both cross-scattering and birefringence of atherosclerotic plaques at various development stages and more reliably reveal their vulnerability.

  9. Accessory renal arteries in a Caribbean population: a computed tomography based study

    OpenAIRE

    Johnson, Peter B.; Cawich, Shamir O.; Shah, Sundeep D; Aiken, William; McGregor, Roy G; Brown, Hilary; Gardner, Michael T.

    2013-01-01

    Introduction The commonest variation to the classic anatomic description of renal arterial supply is the presence of accessory renal arteries. The incidence varies widely according to ethnicity. There is no data on the prevalence of these anomalies in persons of Caribbean ethnicity. Methods All CT scans done over two years from July 1, 2010 to June 30, 2012 were retrospectively evaluated. The anatomy of the renal arterial supply was reported from these studies and the anatomy of accessory ren...

  10. Renal autoregulation in medical therapy of renovascular hypertension

    OpenAIRE

    Lubas, Arkadiusz; Żelichowski, Grzegorz; Próchnicka, Agnieszka; Wiśniewska, Magdalena; Wańkowicz, Zofia

    2010-01-01

    Introduction Renovascular hypertension (RVH) is caused by renal ischaemia associated with haemodynamically significant renal artery stenosis (RAS). The choice of optimal treatment of atherosclerotic RAS is still controversial. Increase in the renal resistive index (RI) value after captopril administration is considered to indicate preserved renal autoregulation. The objective of the study was to assess the effect of medical therapy of RVH on renal autoregulation efficiency in patients with at...

  11. Global gene expression profiling displays a network of dysregulated genes in non-atherosclerotic arterial tissue from patients with type 2 diabetes

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    Skov Vibe

    2012-02-01

    Full Text Available Abstract Background Generalized arterial alterations, such as endothelial dysfunction, medial matrix accumulations, and calcifications are associated with type 2 diabetes (T2D. These changes may render the vessel wall more susceptible to injury; however, the molecular characteristics of such diffuse pre-atherosclerotic changes in diabetes are only superficially known. Methods To identify the molecular alterations of the generalized arterial disease in T2D, DNA microarrays were applied to examine gene expression changes in normal-appearing, non-atherosclerotic arterial tissue from 10 diabetic and 11 age-matched non-diabetic men scheduled for a coronary by-pass operation. Gene expression changes were integrated with GO-Elite, GSEA, and Cytoscape to identify significant biological pathways and networks. Results Global pathway analysis revealed differential expression of gene-sets representing matrix metabolism, triglyceride synthesis, inflammation, insulin signaling, and apoptosis. The network analysis showed a significant cluster of dysregulated genes coding for both intra- and extra-cellular proteins associated with vascular cell functions together with genes related to insulin signaling and matrix remodeling. Conclusions Our results identify pathways and networks involved in the diffuse vasculopathy present in non-atherosclerotic arterial tissue in patients with T2D and confirmed previously observed mRNA-alterations. These abnormalities may play a role for the arterial response to injury and putatively for the accelerated atherogenesis among patients with diabetes.

  12. TRANS-ARTERIAL EMBOLIZATION WITH N-BUTYL CYANOACRYLATE GLUE FOR RENAL BLEEDING: Case Report

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    Benny Young

    2014-08-01

    Full Text Available Background: The objectivity in management of renal bleeding is to preserve a significant renal parenchyma tissue and prevent associated morbidities like anemic shock or renal impairment from substantial nephron demise or obstructed uropathy. Trans-arterial embolization therapy by interventional radiology offers a high success rate with potential of reserving normal renal tissue. The selection material for renal arterial embolization largely depends on vasculature anatomy and end-point of procedure. N-butyl cyanoacrylate glue in our experience is applied in lesion supplied by small size of end-artery

  13. Association between microalbuminuria and subclinical atherosclerosis evaluated by carotid artery intima-media in elderly patients with normal renal function

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    Kong XiangLei

    2012-06-01

    Full Text Available Abstract Background Moderate to severe renal insufficiency and albuminuria have been shown to be independent risk factors for atherosclerosis. However, little is known about the direct association between subclinical atherosclerosis evaluated by carotid artery intima-media thickness (IMT and microalbuminuria in elderly patients with normal renal function. Methods Subjects were 272 elderly patients (age  ≥ 60 years with normoalbuminuria (n = 238 and microalbuminuria (n = 34. Carotid IMT was measured by means of high-resolution B-mode ultrasonography. Estimated glomerular filtration rate (eGFR ≥ 60 ml/min/1.73 m2 was defined as normal renal function. Those who had macroalbuminuria and atherosclerotic vascular disease were not included. Results Compared to subjects with normoalbuminuria, subjects with microalbuminuria had higher mean carotid IMT (1.02 ± 0.38 vs. 0.85 ± 0.28 mm; P  Conclusions A slight elevation of albuminuria is a significant determinant of carotid IMT independent of traditional cardiovascular risk factors in our patients. Our study further confirms the importance of intensive examinations for the early detection of atherosclerosis when microalbuminuria is found in elderly patients, although with normal renal function.

  14. Severe Hypertension Secondary to Renal Artery Stenosis and Cushing's Syndrome

    International Nuclear Information System (INIS)

    We present an unusual patient who simultaneously had severe renal artery stenosis RAS and Cushings syndrome. The case highlights the difficulty of reaching a specific diagnosis of Cushings syndrome and the possible interaction between Cushings syndrome and some other concurrent illnesses that this patient had. A 37-year old man presented with severe hypertension HTN and uncontrolled diabetes mellitus DM without clear physical signs of Cushings syndrome. He was found to have severe osteoporosis, proximal myopathy, several cutaneous warts, tinea versicolor, and chronic viral hepatitis. Captopril-stimulated renal scan and renal artery angiogram revealed severe RAS. Partial balloon dilatation of RAS led to improvement in HTN. Unexpectedly, urine free cortisol 24 hour was found extremely high. Serum adrenocorticotropic hormone ACTH was also elevated and high dose dexamethasone suppression tests were inconclusive. Several imaging studies failed to localize the source of ACTH. Despite normal MRI of the pituitary gland, bilateral inferior petrosal sinus sampling IPSS localized the source of ACTH secretion to the right side of the pituitary gland and right anterior hemihypophysectomy resulted in cure of Cushings disease, HTN, DM, and tinea versicolor with significant improvement in cutaneous warts, osteoporosis, and chronic hepatitis. In conclusion, RAS and Cushings syndrome may occur together. Significant hypercortisolemia can occur without clear signs of Cushings syndrome. Controlling hypercortisolemia is of paramount importance when treating chronic infections in patients with Cushing's syndrome. (author)

  15. Endovascular embolization of pseudoaneurysm of left colic artery developing after renal biopsy

    OpenAIRE

    Madhusudhan, K. S.; Gamanagatti, S.; Gupta, A K

    2015-01-01

    Vascular complications after percutaneous renal biopsy are uncommon and may require interventional management. In most of these cases, the pathology is a renal arterial pseudoaneurysm (PsA) or an arterio-venous fistula. Injury to other vessels like aorta, lumbar arteries or mesenteric arteries is rare with only one case of left colic artery PsA reported in literature. We report a case of a 60-year-old female, who developed left colic artery PsA after renal biopsy, which was successfully embol...

  16. Percutaneous renal artery stenting reduces arterial blood pressure, but what about renal function? A single-center experience

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    Erkan Dervişoğlu

    2010-02-01

    Full Text Available Objective: To assess the effects of percutaneous transluminal angioplasty and stenting (PTRA/S on arterial blood pressure and renal function.Methods: A retrospective chart review of patients undergoing PTRA/S at our institution between December 2003 and September 2006 was done. Follow-up data were derived from hospital records. Estimated glomerular filtration rate (EGFR was used as the marker of renal function. To evaluate the pre- and post-procedure values in individual patients the paired t test and Wilcoxon signed-rank tests were used.Results: Thirty-six patients (16 women, 30 men; mean age 59±15 years, range: 25-83 years underwent 43 PTRA/S interventions at our institution. The mean duration of follow-up was 9.3±8.6 (range 2-28 months. We observed no significant change in EGFR from pre-procedure to that obtained at follow-up (71.4±40.2 mL/min vs.73.3±39.0 mL/min; p=0.483. Mean arterial blood pressure (MABP, however, was reduced significantly: pre-procedure MABP-123±22 mmHg; post-procedure follow-up value of 101±14 mmHg (p <0.001. The mean number of antihypertensive medications used at the time of intervention was 2.1±1.0 (range: 0-4, whereas at follow-up, this number had decreased to 1.3±1.0 (range: 0-4; p<0.001. In patients with renal impairment (EGFR ≤59 mL/min, 41% showed improvement, 29% showed no change and 29% demonstrated deterioration in EGFR. Conclusion: PTRA/S may preserve renal function, especially in patients with pre-procedural impaired renal function.

  17. Role of renal arterial resistive index (RI) in obstructive uropathy

    International Nuclear Information System (INIS)

    Objective: To determine the diagnostic accuracy of renal arterial resistive index on doppler ultrasound in patients with acute renal colic to diagnose obstructive uropathy taking non-enhanced helical computed tomography as the gold standard. Methods: The descriptive study, conducted at the Radiology Department of Pakistan Naval Ship Shifa Hospital, Karachi, from October 10, 2010 to July 17, 2011, comprised 160 patients referred from the Emergency Department with complaint of unilateral renal colic. Ultrasound was carried out. Subsequently, computed tomography scan of kidney, ureter and bladder was performed. Data was collected on prescribed proforma and analysed using SPSS 19. Results: By taking the resistive index value of > 0.70 as a discriminatory level for obstruction, the overall sensitivity of the index was 76.23% and specificity was 88.13%. The positive predictive values of the index in patients with obstructive uropathy was 91.6%, and negative predictive value was calculated to be 68.42%. The diagnostic accuracy of the test was 80%. Conclusion: Duplex Doppler ultrasound can detect acute renal obstruction with sensitivity of approximately 77%. However, ultrasound is an operator-dependent examination, and the results are much affected by patient body habitus. (author)

  18. Long-term estradiol treatment improves VIP-mediated vasodilation in atherosclerotic proximal coronary arteries

    DEFF Research Database (Denmark)

    Dalsgaard, T.; Mortensen, Alicja; Larsen, C. R.;

    2003-01-01

    arteries. Female ovariectomized homozygous Watanabe heritable hyperlipidemic rabbits were randomized to 16 weeks treatment with 17beta-estradiol or placebo. The diet was semisynthetic, thereby avoiding the influence of phytoestrogens. Artery ring segments were mounted for isometric tension recordings in...... myographs. Following precontraction, the dose-response relationships for VIP and PACAP were evaluated. Treatment with 17beta-estradiol significantly improved the maximum VIP-mediated vasodilation (E-max, percentage of precontraction) in proximal coronary arteries (45.8 +/- 9.6% vs. 24.1 +/- 3.7%, p <0...... differences for the potassium or VIP responses in cerebral or distal coronary arteries were found between the two groups. 17beta-estradiol induced no changes in the PACAP-mediated vasodilation. These results suggest that long-term treatment with 17beta-estradiol improves the VIP-mediated but not the PACAP...

  19. Juvenile elastic arteries after 28 years of renal replacement therapy in a patient with complete complement C4 deficiency

    Directory of Open Access Journals (Sweden)

    Knoll Florian

    2012-12-01

    Full Text Available Abstract Background Complement activation products are present in atherosclerotic plaques. Recently, binding of complement to elastin and collagen in the aortic wall has been demonstrated, suggesting a role of complement in the development aortic stiffness and atherosclerosis. The definitive role of complement in atherosclerosis and arteriosclerosis, however, remains unclear. Case presentation We here describe a patient with hereditary complete deficiency of complement C4 suffering from Henoch-Schoenlein purpura and on renal replacement therapy for twenty-eight years. The patient had the full range of risk factors for vascular damage such as hypertension, volume overload, hyperphosphatemia and hyperparathyroidism. Despite that, his carotid artery intima media thickness was below the normal range and his pulse wave velocity was normal. In contrast, the patient’s coronary and peripheral muscular arteries were heavily calcified. Conclusion This case supports the hypothesis that complement plays an important role in the development of stiffness of elastic arteries. We speculate that inability to activate complement by the classical or lectin pathways protected the patient from atherosclerosis, arteriosclerosis, stiffening and calcification of the aorta and carotid arteries. Inhibition of complement activation may be a potential target for prophylactic and therapeutic interventions.

  20. Atherosclerotic plaque volume and composition in symptomatic carotid arteries assessed with multidetector CT angiography; relationship with severity of stenosis and cardiovascular risk factors

    International Nuclear Information System (INIS)

    The purpose of this study was to examine the volume and the composition of atherosclerotic plaque in symptomatic carotid arteries and to investigate the relationship between these plaque features and the severity of stenosis and the presence of cardiovascular risk factors. One hundred patients with cerebrovascular symptoms underwent CT angiography. We measured plaque volume (PV) and the relative contribution of plaque components (calcifications, fibrous tissue, and lipid) in the symptomatic artery. The contribution of different components was measured as the number of voxels within defined ranges of HU values (calcification >130 HU, fibrous tissue 60-130 HU, lipid core <60 HU). Fifty-seven patients had atherosclerotic plaque in the symptomatic carotid artery. The severity of stenosis and PV were moderately correlated. Age and smoking were independently related to PV. Patients with hypercholesterolemia had significantly less lipid and more calcium in their plaques than patients without hypercholesterolemia. Other cardiovascular risk factors were not significantly related to PV or plaque composition. Luminal stenosis of the carotid artery partly reflects the amount of atherosclerotic carotid disease. Plaque volume and plaque composition are associated with cardiovascular risk factors. (orig.)

  1. Atherosclerotic plaque volume and composition in symptomatic carotid arteries assessed with multidetector CT angiography; relationship with severity of stenosis and cardiovascular risk factors

    Energy Technology Data Exchange (ETDEWEB)

    Rozie, S.; Weert, T.T. de; Monye, C. de; Homburg, P.J.; Tanghe, H.L.J.; Lugt, A. van der [Erasmus MC, University Medical Center Rotterdam, Departments of Radiology, Rotterdam (Netherlands); Dippel, D.W.J. [Erasmus MC, University Medical Center Rotterdam, Department of Neurology, PO Box 2040, Rotterdam (Netherlands)

    2009-09-15

    The purpose of this study was to examine the volume and the composition of atherosclerotic plaque in symptomatic carotid arteries and to investigate the relationship between these plaque features and the severity of stenosis and the presence of cardiovascular risk factors. One hundred patients with cerebrovascular symptoms underwent CT angiography. We measured plaque volume (PV) and the relative contribution of plaque components (calcifications, fibrous tissue, and lipid) in the symptomatic artery. The contribution of different components was measured as the number of voxels within defined ranges of HU values (calcification >130 HU, fibrous tissue 60-130 HU, lipid core <60 HU). Fifty-seven patients had atherosclerotic plaque in the symptomatic carotid artery. The severity of stenosis and PV were moderately correlated. Age and smoking were independently related to PV. Patients with hypercholesterolemia had significantly less lipid and more calcium in their plaques than patients without hypercholesterolemia. Other cardiovascular risk factors were not significantly related to PV or plaque composition. Luminal stenosis of the carotid artery partly reflects the amount of atherosclerotic carotid disease. Plaque volume and plaque composition are associated with cardiovascular risk factors. (orig.)

  2. Reversal of end-stage renal disease after aortic dissection using renal artery stent: a case report

    Directory of Open Access Journals (Sweden)

    Parikh Chirag R

    2004-05-01

    Full Text Available Abstract Background Medical management is the conventional treatment for Stanford Type B aortic dissections as surgery is associated with significant morbidity and mortality. The advent of endovascular interventional techniques has revived interest in treating end-organ complications of Type B aortic dissection. We describe a patient who benefited from endovascular repair of renal artery stenosis caused by a dissection flap, which resulted in reversal of his end-stage renal disease (ESRD. Case presentation A 69 y/o male with a Type B aortic dissection diagnosed two months earlier was found to have a serum creatinine of 15.2 mg/dL (1343.7 μmol/L on routine visit to his primary care physician. An MRA demonstrated a rightward spiraling aortic dissection flap involving the origins of the celiac artery, superior mesenteric artery, and both renal arteries. The right renal artery arose from the false lumen with lack of blood flow to the right kidney. The left renal artery arose from the true lumen, but an intimal dissection flap appeared to be causing an intermittent stenosis of the left renal artery with compromised blood flow to the left kidney. Endovascular reconstruction with of the left renal artery with stent placement was performed. Hemodialysis was successfully discontinued six weeks after stent placement. Conclusion Percutaneous intervention provides a promising alternative for patients with Type B aortic dissections when medical treatment will not improve the likelihood of meaningful recovery and surgery entails too great a risk. Nephrologists should therefore be aggressive in the workup of ischemic renal failure associated with aortic dissection as percutaneous intervention may reverse the effects of renal failure in this population.

  3. Concomitant atherosclerotic disease detected by whole-body MR angiography in relation to coronary artery calcification in patients with coronary artery disease

    Energy Technology Data Exchange (ETDEWEB)

    Seng, K.; Schlosser, T.; Barkhausen, J.; Ladd, S.C. [Universitaetsklinikum Essen (Germany). Abt. fuer Diagnostische und Interventionelle Radiologie und Neuroradiologie; Breuckmann, F.; Geckeis, K.; Schmermund, A.; Erbel, R. [Universitaetsklinikum Essen (Germany). Abt. fuer Kardiologie, Westdeutsches Herzzentrum Essen; Budde, T.; Hoefs, C. [Krupp Krankenhaus, Essen (Germany). Abt. fuer Kardiologie

    2010-04-15

    Purpose: Patients with coronary artery disease (CAD) show a high prevalence for concomitant atherosclerotic peripheral arterial disease (PAD). On the other hand, PAD seems to be an additional risk factor for cardiac events. We evaluated the correlation between arterial pathologies as found in whole-body MR angiography and coronary artery calcification (CAC) detected by electron beam computed tomography (EBCT) and multislice CT (MSCT). Materials and Methods: Two hundred and twenty-eight patients (161 men; 67 women) with suspicion for CAD/known CAD underwent whole-body contrast-enhanced MR angiography (wb-ce-MRA) and EBCT/MSCT. An atherosclerosis index was calculated for each patient Index = sum {sub n=1}{sup 40}w{sub i} with w{sub i} being the grading of the stenosis of the i{sup ten} of 40 arteria segments (grade: 0 - no plaque; 1 - plaque - {<=} 50 % stenosis; 2 - > 50 % stenosis - {<=} 90 % stenosis; 3 - > 90 % stenosis - < 100 % stenosis; 4 - occlusion). Correlations between CAC and atherosclerosis index were performed. Results: Wb-ce MRA and CAC correlate only moderately in this population. An atherosclerosis index 8 renders a positive predictive value for a CAC 100 of 63.3 %. Conclusion: An atherosclerosis index as defined in this study does not fully correlate with the extent of CAD as revealed by catheter angiography or EBCT/MSCT, but it might theoretically mirror the increased risk by PAD. It thus might be a promising complementary parameter for the prediction of cardiac events. Future studies need to show its possible additional predictive impact.

  4. In-vivo quantitative T2 mapping of carotid arteries in atherosclerotic patients: segmentation and T2 measurement of plaque components

    OpenAIRE

    Biasiolli, Luca; Lindsay, Alistair C.; Chai, Joshua T.; Choudhury, Robin P.; Robson, Matthew D

    2013-01-01

    Background Atherosclerotic plaques in carotid arteries can be characterized in-vivo by multicontrast cardiovascular magnetic resonance (CMR), which has been thoroughly validated with histology. However, the non-quantitative nature of multicontrast CMR and the need for extensive post-acquisition interpretation limit the widespread clinical application of in-vivo CMR plaque characterization. Quantitative T2 mapping is a promising alternative since it can provide absolute physical measurements o...

  5. Atherosclerotic plaque volume and composition in symptomatic carotid arteries assessed with multidetector CT angiography; relationship with severity of stenosis and cardiovascular risk factors

    OpenAIRE

    Rozie, S.; de Weert, T. T.; de Monyé, C.; Homburg, P. J.; Tanghe, H L J; Dippel, D W J; van der Lugt, A.

    2009-01-01

    The purpose of this study was to examine the volume and the composition of atherosclerotic plaque in symptomatic carotid arteries and to investigate the relationship between these plaque features and the severity of stenosis and the presence of cardiovascular risk factors. One hundred patients with cerebrovascular symptoms underwent CT angiography. We measured plaque volume (PV) and the relative contribution of plaque components (calcifications, fibrous tissue, and lipid) in the symptomatic a...

  6. Paclitaxel-Coated Balloons: Investigation of Drug Transfer in Healthy and Atherosclerotic Arteries – First Experimental Results in Rabbits at Low Inflation Pressure

    OpenAIRE

    Stolzenburg, Nicola; Breinl, Janni; Bienek, Stephanie; Jaguszewski, Milosz; Löchel, Melanie; Taupitz, Matthias; Speck, Ulrich; Wagner, Susanne; Schnorr, Jörg

    2016-01-01

    Purpose Beyond antiproliferative properties, paclitaxel exhibits anti-inflammatory activity, which might be beneficial in the local treatment of nonocclusive coronary artery disease. Paclitaxel release and tissue concentrations after paclitaxel-coated balloon treatment using different pressures have not been investigated so far. The aim of the study was to investigate in an atherosclerotic rabbit model whether drug transfer from paclitaxel-coated balloons into the vessel wall is affected by t...

  7. Modification of the No-Touch Technique during Renal Artery Stenting

    Directory of Open Access Journals (Sweden)

    John A. Stathopoulos

    2013-01-01

    Full Text Available Renal artery stenting has been established as the primary form of renal artery stenosis revascularization procedure. The no-touch technique is proposed in order to avoid renal artery injury and atheroembolism during renal artery stenting. We describe a modification of the no-touch technique by using an over-the-wire (OTW balloon or a Quickcross catheter with a coronary wire inside, instead of the rigid  J wire. The reported technique, while it prevents direct contact of the guiding catheter with the aortic wall, at the same time it allows for a closer contact with the renal arterial ostium and a more favorable guiding catheter orientation, compared to what is achieved with the use of the more rigid  J wire, thus improving visualization, reducing the amount of contrast required, and potentially decreasing complications.

  8. 3D-NMR angiography of atherosclerotic carotid and vertebral artery disease

    International Nuclear Information System (INIS)

    Magnetic Resonance Angiography was performed as part of a routine brain examination, and to assess the potential of MRA as a noninvasive modality to display the peripheral carotid and the vertebral artery in the diagnosis of cerebrovascular disease. (author). 8 refs.; 3 figs

  9. Angiography of renal artery with special reference to the blood supply of the kidney in camel

    International Nuclear Information System (INIS)

    The vascular system of kidney of the camel is strikingly different from that of other domestic animals. The right and left renal arteries emanated independently from the ventrolateral aspect of abdominal aorta behind cranial mesenteric artery at the level of cranial border of third and fourth lumbar vertebra respectively. The renal artery after short lateral course divided into medial and lateral lobar arteries before reaching the hilus. The lobar artery after entering into the hilus gave 9-11 interlobar arteries. These interlobar arteries at the corticomedullary junction formed 2 - 7 arcuate arteries. The arcuate arteries detached numerous straight branches from their convex surfaces and then ended by dividing into 2 - 4 terminal branches. The straight branches and the terminal branches were present in a radiating manner as interlobular arteries

  10. Platelet activation, function, and reactivity in atherosclerotic carotid artery stenosis: a systematic review of the literature.

    LENUS (Irish Health Repository)

    Kinsella, J A

    2012-09-27

    An important proportion of transient ischemic attack or ischemic stroke is attributable to moderate or severe (50-99%) atherosclerotic carotid stenosis or occlusion. Platelet biomarkers have the potential to improve our understanding of the pathogenesis of vascular events in this patient population. A detailed systematic review was performed to collate all available data on ex vivo platelet activation and platelet function\\/reactivity in patients with carotid stenosis. Two hundred thirteen potentially relevant articles were initially identified; 26 manuscripts met criteria for inclusion in this systematic review. There was no consistent evidence of clinically informative data from urinary or soluble blood markers of platelet activation in patients with symptomatic moderate or severe carotid stenosis who might be considered suitable for carotid intervention. Data from flow cytometry studies revealed evidence of excessive platelet activation in patients in the early, sub-acute, or late phases after transient ischemic attack or stroke in association with moderate or severe carotid stenosis and in asymptomatic moderate or severe carotid stenosis compared with controls. Furthermore, pilot data suggest that platelet activation may be increased in recently symptomatic than in asymptomatic severe carotid stenosis. Excessive platelet activation and platelet hyperreactivity may play a role in the pathogenesis of first or subsequent transient ischemic attack or stroke in patients with moderate or severe carotid stenosis. Larger longitudinal studies assessing platelet activation status with flow cytometry and platelet function\\/reactivity in symptomatic vs. asymptomatic carotid stenosis are warranted to improve our understanding of the mechanisms responsible for transient ischemic attack or stroke.

  11. Endovascular Renal Artery Denervation: Why, When, and How?

    International Nuclear Information System (INIS)

    Endovascular renal artery denervation (ERAD) is a new procedure to reduce renal and systemic sympathetic overactivity in hypertensive patients. The role of sympathetic overactivity is recognized since a long time as being one the contributor of human hypertension. In support of this view, several studies in experimental models of hypertension in animal as well as hypertensive human subjects have demonstrated that sympathetic overactivity plays a central role in hypertension catheter based renal denervation is now possible, and this procedure may provide a useful adjunct for the management of patients with drug-resistant primary hypertension. Following a cohort study, the results of an open label randomized control trial have been published showing very encouraging results. The purpose of this paper is to help interventionalists to better understand the medical and technical issues related to this new intervention. It is most likely that as underlined in a recent editorial several other technical approaches may appear in the future, however because this is the only technique that is available today, we will focus on radiofrequency based technique.

  12. MR velocity mapping measurement of renal artery blood flow in patients with impaired kidney function

    DEFF Research Database (Denmark)

    Cortsen, M; Petersen, L.J.; Stahlberg, F;

    1996-01-01

    . MR velocity mapping was performed in both renal arteries using an ECG-triggered gradient echo pulse sequence previously validated in normal volunteers. Effective renal plasma flow was calculated from the clearance rate of PAH during constant infusion and the split of renal function was evaluated by...

  13. Coarctation of the aorta and renal artery stenosis in tuberous sclerosis

    International Nuclear Information System (INIS)

    Among neurocutaneous disorders, coarctation of the abdominal aorta and renal artery stenosis have traditionally been associated with neurofibromatosis. We report a 5-year-old girl who was discovered to have bilateral renal artery stenosis, coarctation of the abdominal aorta, renal cysts and typical skin lesions of tuberous clerosis during the evaluation of asymptomatic hypertension. Renal vascular hypertension has not been reported previously in tuberous sclerosis. We conclude that the tuberous sclerosis complex should be expanded to include vascular malformations and the hypertension should not be assumed to be secondary to renal hamartomata or cysts in patients with tuberous sclerosis. (orig.)

  14. Isolated single umbilical artery--the case for routine renal screening.

    OpenAIRE

    Bourke, W G; Clarke, T. A.; Mathews, T. G.; O'Halpin, D; Donoghue, V B

    1993-01-01

    To determine the incidence of silent renal anomalies in infants with isolated single umbilical artery (SUA), all infants with SUA and without other obvious congenital anomalies, identified over a six year period, were screened using renal ultrasonography. Over 35,000 placentas were examined. An isolated single umbilical artery was identified in 112 (0.32%). Nineteen infants had abnormal renal imaging. Eight of 112 (7.1%) had significant persisting abnormalities. Vesicoureteric reflux was foun...

  15. Novel methods for accurate identification, isolation, and genomic analysis of symptomatic microenvironments in atherosclerotic arteries.

    Science.gov (United States)

    Slevin, Mark; Baldellou, Maribel; Hill, Elspeth; Alexander, Yvonne; McDowell, Garry; Murgatroyd, Christopher; Carroll, Michael; Degens, Hans; Krupinski, Jerzy; Rovira, Norma; Chowdhury, Mohammad; Serracino-Inglott, Ferdinand; Badimon, Lina

    2014-01-01

    A challenge facing surgeons is identification and selection of patients for carotid endarterectomy or coronary artery bypass/surgical intervention. While some patients with atherosclerosis develop unstable plaques liable to undergo thrombosis, others form more stable plaques and are asymptomatic. Identification of the cellular signaling mechanisms associated with production of the inflammatory, hemorrhagic lesions of mature heterogenic plaques will help significantly in our understanding of the differences in microenvironment associated with development of regions susceptible to rupture and thrombosis and may help to predict the risk of plaque rupture and guide surgical intervention to patients who will most benefit. Here, we demonstrate detailed and novel methodologies for successful and, more importantly, accurate and reproducible extraction, sampling, and analysis of micro-regions in stable and unstable coronary/carotid arteries. This information can be applied to samples from other origins and so should be useful for scientists working with micro-isolation techniques in all fields of biomedical science. PMID:24510873

  16. Data on the lipoprotein (a), coronary atherosclerotic burden and vulnerable plaque phenotype in angiographic obstructive coronary artery disease.

    Science.gov (United States)

    Niccoli, Giampaolo; Chin, Diana; Scalone, Giancarla; Panebianco, Mario; Abbolito, Sofia; Cosentino, Nicola; Jacoangeli, Francesca; Refaat, Hesham; Gallo, Giovanna; Salerno, Gerardo; Volpe, Massimo; Crea, Filippo; De Biase, Luciano

    2016-06-01

    Lipoprotein Lp(a) represents an independent risk factor for coronary artery disease (CAD). However, its association with CAD burden and lipid rich plaques prone to rupture in patients with acute coronary syndrome (ACS) still remains unknown. These data aim to investigate the association among serum Lipoprotein(a) (Lpa) levels, coronary atherosclerotic burden and features of culprit plaque in patients with ACS and obstructive CAD. For his reason, a total of 500 ACS patients were enrolled for the angiographic cohort and 51 ACS patients were enrolled for the optical coherence tomography (OCT) cohort. Angiographic CAD severity was assessed by Sullivan score and by Bogaty score including stenosis score and extent index, whereas OCT plaque features were evaluated at the site of the minimal lumen area and along the culprit segment. In the angiographic cohort, Lp(a) was a weak independent predictor of Sullivan score (p30 md/dl) compared to patients with lower Lp(a) levels (<30 md/dl) exhibited a higher prevalence of lipidic plaque at the site of the culprit stenosis (P=0.02), a wider lipid arc (p=0.003) and a higher prevalence of thin-cap fibroatheroma (p=0.004). PMID:27158659

  17. Angiography for renal artery stenosis: no additional impairment of renal function by angioplasty

    Energy Technology Data Exchange (ETDEWEB)

    Lufft, Volkmar; Fels, Lueder M.; Egbeyong-Baiyee, Daniel; Olbricht, Christoph J. [Abteilung Nephrologie, Medizinische Hochschule Hannover (Germany); Hoogestraat-Lufft, Linda; Galanski, Michael [Abteilung Diagnostische Radiologie, Medizinische Hochschule Hannover (Germany)

    2002-04-01

    The aim of this study was to compare renal function between patients with renal angiography and patients with renal angiography and angioplasty (AP) for renal artery stenosis (RAS). Forty-seven patients with suspected RAS were prospectively investigated by digital subtraction angiography (DSA) using non-ionic low osmolar contrast media (CM). In 22 patients RAS was detected and in 16 cases an angioplasty was performed in the same session. The following parameters were determined 1 day prior to and after the DSA, respectively: serum creatinine (S-Crea, {mu}mol/l) and single-shot inulin clearance (In-Cl, ml/min) for the evaluation of renal function; and urine alpha 1-microglobuline (AMG, {mu}g/g Crea) and beta-N-acetyl-glucoseaminidase (beta-NAG, U/g Crea) as markers of tubular toxicity. Serum creatinine was measured additionally 2 days after CM had been injected. In both groups with and without AP 174{+-}65 and 104{+-}56 ml of CM (p<0.0005) were used, respectively. There were no differences with regard to renal function or risk factors for CM nephrotoxicity between both groups. In the group with AP S-Crea and In-Cl (each: mean{+-}SD) did not change significantly (before DSA: 171{+-}158 and 61{+-}24, after DSA: 189{+-}177 and 61{+-}25, respectively), beta-NAG (median) rose from 4 to 14 (p<0.05) and AMG from 8 to 55 (n.s., because of high SD). In the group without AP S-Crea increased from 134{+-}109 to 141{+-}113 (p<0.01), In-Cl dropped from 65{+-}26 to 62{+-}26 (p<0,01), beta NAG (median) rose from 4 to 8 (p=0.01), and AMG from 7 to 10 (n.s.). A rise in baseline S-Crea by more than 25% or 44 {mu}mol/l occurred in 4 and 2 patients in the group with and without AP, respectively. Creatinine increase was reversible in all cases within 7 days. In this study using sensitive methods to detect changes of renal function and tubular toxicity no additional renal function impairment in DSA with angioplasty for RAS compared with DSA alone could be demonstrated. Our data suggest

  18. Interleukin-18 Gene Polymorphism in Patients with and without Atherosclerotic Coronary Artery Disease

    OpenAIRE

    A Ghaderi; Erfani, N.; MR Haghshenas; MJ ZibaeeNezhad; AR Abdi; Shayan, S.

    2009-01-01

    Background:Several studies have revealed that inflammation plays an important role in development of Coronary Artery Disease (CAD) and its other manifestations. IL-18 is a pleiotropic cytokine that enhances Th1( T helper 1) or Th2( T helper 2) immune response depending on its cytokine milieu and genetic background. It strongly induces formation of plaques in patients with CAD. Variations in the IL-18 gene found to influence both levels of IL-18 and clinical outcomes in individuals with histor...

  19. Carotid and femoral atherosclerotic plaques show different morphology. : Patterns of Peripheral Arterial Disease

    OpenAIRE

    Herisson, Fanny; Heymann, Marie-Françoise; Chétiveaux, Maud; Charrier, Céline; Battaglia, Séverine; Pilet, Paul; Rouillon, Thierry; Krempf, Michel; Lemarchand, Patricia; Heymann, Dominique; Gouëffic, Yann

    2011-01-01

    OBJECTIVE: Results of endovascular repair vary according to the arterial bed. We hypothesized that these differences may be related to the plaque features. To explore this hypothesis, we designed a prospective study that compared carotid and femoral atheroma. METHODS AND RESULTS: Patients that underwent femoral or carotid endarterectomy were included in our study. Demographic data and blood sampling were obtained prior to surgery. Plaques were evaluated for AHA grading, calcification and lipi...

  20. Local blood pressure associates with the degree of luminal stenosis in patients with atherosclerotic disease in the middle cerebral artery.

    Science.gov (United States)

    Jiang, Yuanliang; Peng, Wenjia; Teng, Zhongzhao; Gillard, Jonathan H; Hong, Bo; Liu, Qi; Lu, Jianping

    2016-01-01

    The mechanism underlying atherosclerotic ischemic events within the middle cerebral artery (MCA) is unclear. High structural stress induced by blood pressure might be a potential aetiology as plaque rupture occurs when such mechanical loading exceeds its material strength. To perform reliable analyses quantifying the mechanical loading within a plaque, the local blood pressure is needed. However, data on MCA blood pressure is currently lacking. In this study, the arterial pressure proximal to the stenotic site in the MCA was measured in 15 patients scheduled for intervention. The relationships between these local measurements and pre-intervention and intra-intervention non-invasive arm measurements were assessed. The impact of luminal stenosis on the local blood pressure was quantified. Compared with the pre-intervention arm measurement, the intra-intervention arm pressure decreased significantly by 23.9 ± 11.8 and 9.3 ± 14.7 % at diastole and systole, respectively. The pressure proximal to the stenosis was much lower than the pre-intervention arm measurement (diastole: 65.3 ± 15.7 vs 82.0 ± 9.7, p pressure in the MCA in patients with stenosis pressure (22.8 ± 6.4 vs 11.1 ± 8.3, p = 0.01; unit: mmHg). However, diastolic pressure remained unaffected (69.2 ± 9.3 vs 62.8 ± 19.0, p = 0.58; unit: mmHg). In conclusion, the obtained results are helpful in understanding the local hemodynamic environment modulated by the presence of atherosclerosis. The local pressure measurements can be used for computational analysis to quantify the critical mechanical condition within an MCA lesion. PMID:27349223

  1. Management of renal artery stenosis: What does the experimental evidence tell us?

    Institute of Scientific and Technical Information of China (English)

    Mohammed; Al-Suraih; Joseph; Peter; Grande

    2014-01-01

    Optimal management of patients with renal artery stenosis(RAS) is a subject of considerable controversy. There is incontrovertible evidence that renal artery stenosis has profound effects on the heart and cardiovascular system in addition to the kidney. Recent evidence indicates that restoration of blood flow alone does not improve renal or cardiovascular outcomes in patients with renal artery stenosis. A number of human and experimental studies have documented the clinical, hemodynamic, and histopathologic features in renal artery stenosis. New approaches to the treatment of renovascular hypertension due to RAS depend on better understanding of basic mechanisms underlying the development of chronic renal disease in these patients. Several groups have employed the two kidney one clip model of renovascular hypertension to define basic signaling mechanisms responsible for the development of chronic renal disease. Recent studies have underscored the importance of inflammation in the development and progression of renal damage in renal artery stenosis. In particular, interactions between the renin-angiotensin system, oxidative stress, and inflammation appear to play a critical role in this process. In this overview, results of recent studies to define basic pathways responsible for renal disease progression will be highlighted. These studies may provide the rationale for novel therapeutic approaches to treat patients with renovascular hypertension.

  2. Early atherosclerosis aggravates renal microvascular loss and fibrosis in swine renal artery stenosis.

    Science.gov (United States)

    Sun, Dong; Eirin, Alfonso; Ebrahimi, Behzad; Textor, Stephen C; Lerman, Amir; Lerman, Lilach O

    2016-04-01

    Renal function in patients with atherosclerosis and renal artery stenosis (ARAS) deteriorates more frequently than in nonatherosclerotic RAS. We hypothesized that ARAS aggravates stenotic-kidney micro vascular loss compared to RAS. Domestic pigs were randomized to normal, RAS, and ARAS (RAS fed a high-cholesterol diet) groups (n = 7 each). Ten weeks later stenotic-kidney oxygenation, renal blood flow, and glomerular filtration rate (GFR) were evaluated in vivo, and micro vascular density by micro-computed tomography. Blood pressure in both RAS and ARAS was elevated; and stenotic-kidney renal blood flow and GFR similarly decreased. RAS decreased the density of small-size cortical microvessels (sized microvessels (200-300 μm). Cortical hypoxia and interstitial fibrosis increased in both RAS and ARAS but correlated inversely with micro vascular density only in RAS. Atherosclerosis aggravates loss of stenotic-kidney microvessels, yet additional determinants likely contribute to cortical hypoxia and fibrosis in swine ARAS. PMID:26879682

  3. Interleukin-18 Gene Polymorphism in Patients with and without Atherosclerotic Coronary Artery Disease

    Directory of Open Access Journals (Sweden)

    A Ghaderi

    2009-09-01

    Full Text Available Background:Several studies have revealed that inflammation plays an important role in development of Coronary Artery Disease (CAD and its other manifestations. IL-18 is a pleiotropic cytokine that enhances Th1( T helper 1 or Th2( T helper 2 immune response depending on its cytokine milieu and genetic background. It strongly induces formation of plaques in patients with CAD. Variations in the IL-18 gene found to influence both levels of IL-18 and clinical outcomes in individuals with history of heart disease. To investigate the association of two IL-18 promoter gene polymorphisms at -607C/A and -137G/C positions with CAD, and some CAD risk factors such as diabetes, arterial hypertension, hypercholesterolemia, cigarette smoking and obesity.Methods: Genomic DNA was extracted by the salting out method from the peripheral arterial blood of 280 patients with CAD documented by coronary angiography (143 with a documented history of myocardial infarction termed positive MI and 137 without myocardial infarction designated negative MI and 140 age- sex matched persons with a normal coronary angiography (control group.The genotype of both CAD and control groups were assessed by ASP-PCR method. Arlequin program was used for gametic phase estimation and haplotype analysis.Results: There was no significant difference between patient and control groups either allelic, genotypic, and haplotypic for both variants (p>0.05. Furthermore, no significant correlation was found between IL-18 genotypes and CAD risk factors in the patient group (P>0.05. Conclusion: These results suggest that the investigated IL-18 gene promoter polymorphisms at -607C/A and -137G/C positions are not associated with genetic susceptibility to CAD in southern Iran.

  4. Short-term effects of renal transplantation on coronary artery calcification: A prospective study

    OpenAIRE

    Pratyusha Priyadarshini; Sandeep Aggarwal; Sandeep Guleria; Sanjiv Sharma; Gurpreet Singh Gulati

    2015-01-01

    Cardiovascular disease is a leading cause of mortality in renal transplant recipients. Coronary artery calcification (CAC) has been found to have good correlation with atherosclerosis and cardiovascular morbidity. The objective of our study was to assess the prevalence of CAC and the long-term effects of renal transplantation on CAC and carotid intima-medial thickness (CIMT) in Indian renal transplant recipients. Twenty-eight renal transplant recipients were included in this prospective study...

  5. Repeatability of in vivo quantification of atherosclerotic carotid artery plaque components by supervised multispectral classification

    OpenAIRE

    Gao, Shan; van ’t Klooster, Ronald; van Wijk, Diederik F.; Nederveen, Aart J.; Lelieveldt, Boudewijn P.F.; van der Geest, Rob J.

    2015-01-01

    Objective To evaluate the agreement and scan–rescan repeatability of automated and manual plaque segmentation for the quantification of in vivo carotid artery plaque components from multi-contrast MRI. Materials and methods Twenty-three patients with 30–70 % stenosis underwent two 3T MR carotid vessel wall exams within a 1 month interval. T1w, T2w, PDw and TOF images were acquired around the region of maximum vessel narrowing. Manual delineation of the vessel wall and plaque components (lipid...

  6. Acute arterial occlusion - kidney

    Science.gov (United States)

    ... arterial thrombosis; Renal artery embolism; Acute renal artery occlusion; Embolism - renal artery ... often result in permanent kidney failure. Acute arterial occlusion of the renal artery can occur after injury ...

  7. Coexistence of pheochromocytoma/praganglioma and renal artery stenosis

    Directory of Open Access Journals (Sweden)

    Vijaya Sarathi

    2012-01-01

    Full Text Available Renal artery stenosis (RAS often coexists with pheochromocytoma (Pheo/paraganglioma (PGL and often alters the management of patients with Pheo/PGL. We have studied the prevalence of RAS in our Pheo/PGL patients. The study included 70 consecutive, histopathologically proven Pheo/PGL patients from a tertiary health care center. In 60 patients, tumors were limited to adrenal glands (54 unilateral and 6 bilateral while other 10 patients had extra-adrenal abdominal tumors. Five patients had RAS with an overall prevalence of 14%. Only two out of 60 patients with Pheo had RAS with a low prevalence of 3.3% while three out of 10 patients with extra-adrenal abdominal PGL had RAS with a prevalence of 30%. To conclude, RAS commonly coexists with Pheo/PGL, more often with extra-adrenal PGL.

  8. Hemodynamic evaluation of uterine artery and renal artery in preeclampsia patients and its relationship with endothelial function and invasive function

    Institute of Scientific and Technical Information of China (English)

    Ping-Feng Shu; Peng Wang

    2015-01-01

    Objective:To study the hemodynamic condition of uterine artery and renal artery in preeclampsia patients and its relationship with endothelial function and invasive function. Methods:Preeclampsia puerperas were enrolled in observation group of the research, including 20 cases each with mild preeclampsia, moderate preeclampsia and severe preeclampsia; healthy puerperas were enrolled in control group. Then color Doppler ultrasound was used to detect hemodynamic parameters of uterine spiral artery and bilateral renal interlobar artery, enzyme-linked immunosorbent assay was used to detect endothelial function indexes in serum, and PCR was used to detect invasive function parameters in placenta.Results: S/D, PI and RI of uterine spiral artery and bilateral renal interlobar artery in mild, moderate and severe preeclampsia patients were all higher than those of control group; the more severe the preeclampsia condition was, the higher the S/D, PI and RI of uterine spiral artery and bilateral renal interlobar artery were; mRNA contents of Cst L, Cst D and MMP-9 in placenta of mild, moderate and severe preeclampsia patients were lower than those of control group, and mRNA contents of RECK as well as serum sFlt-1, sEng, AT1-AA and AngII contents were higher than those of control group; the more severe the disease degree was, the lower the mRNA contents of Cst L, Cst D, and MMP-9 were, the higher the mRNA contents of RECK as well as serum sFlt-1, sEng, AT1-AA and AngII contents were.Conclusion:Resistance of uterine artery and renal artery in preeclampsia patients increases, and it is closely related to endothelial dysfunction and invasive function loss.

  9. Chlamydia pneumoniae in atherosclerotic carotid artery plaques: high prevalence among heavy smokers.

    Science.gov (United States)

    Dobrilovic, N; Vadlamani, L; Meyer, M; Wright, C B

    2001-06-01

    This study was designed to determine the prevalence of Chlamydia pneumoniae in carotid artery plaques. Although there have been numerous studies evaluating coronary plaques for this bacterium fewer studies have assessed noncoronary vasculature. In addition we wished to evaluate whether correlation exists between the presence of C. pneumoniae in carotid plaques and established risk factors for atherosclerosis. Sixty intact carotid artery plaques removed during surgery (carotid endarterectomy) were formalin-fixed and paraffin-embedded according to conventional techniques. These samples were evaluated by polymerase chain reaction analysis to detect presence of C. pneumoniae DNA. Results were tabulated and compared against established risk factors for atherosclerosis: diabetes, hypertension, hyperlipidemia, age, and smoking. Forty-two (70.0%) of the 60 plaques that were evaluated tested positive for the presence of C. pneumoniae DNA by polymerase chain reaction analysis. In the sample defined as being from heavy smokers (greater than 15-pack-year history) 33 (94.3%) of 35 plaques tested positive whereas two (5.7%) tested negative. This correlation demonstrated statistical significance (P = 1.36 x 10(-6), two-tailed Fisher exact test). Presence of C. pneumoniae in carotid plaques demonstrated no statistically significant correlation with diabetes, hypertension, or hyperlipidemia. Age as a risk factor was examined but not statistically evaluated because of the narrow range within our patient sample. Analysis of the data reveals that C. pneumoniae is present in large numbers of atheromatous plaques as is consistent with emerging data. What is interesting though is that 33 (94.3%) of the 35 smokers had plaques that tested positive for the bacterium as opposed to only nine (36.0%) of the 25 nonsmokers. Identification of specific populations exhibiting a high prevalence of C. pneumoniae may serve to focus future studies. Ongoing investigation will seek to determine whether C

  10. In Vivo Flow Measurements of Murine Renal Arteries and Veins with High Frequency Ultrasound

    OpenAIRE

    Bogucki, Amy E; Schroeder, Hilary D.; Yrineo, Alexa A.; Goergen, Craig J.

    2013-01-01

    The number of glomeruli in the kidneys has been shown to have an effect on the decline in renal function over time (Brenner, Garcia, Anderson 1988). Furthermore, flow in the renal arteries and veins may depend on the number of glomeruli in the kidney. Consistent in vivo measurements of volumetric flow in the renal arteries and veins are difficult to obtain. Thus, the purpose of this study was to develop non-invasive imaging techniques capable of estimating arterial and venous flow to kidneys....

  11. Flow Quantification from 2D Phase Contrast MRI in Renal Arteries Using Clustering

    Science.gov (United States)

    Zöllner, Frank G.; Monnsen, Jan Ankar; Lundervold, Arvid; Rørvik, Jarle

    We present an approach based on clustering to segment renal arteries from 2D PC Cine MR images to measure blood velocity and flow. Such information are important in grading renal artery stenosis and support the decision on surgical interventions like percutan transluminal angioplasty. Results show that the renal arteries could be extracted automatically and the corresponding velocity profiles could be calculated. Furthermore, the clustering could detect possible phase wrap effects automatically as well as differences in the blood flow patterns within the vessel.

  12. Clinical Study on Effect of Garlicin in Stabilizing the Carotid Artery Atherosclerotic Plaque in Patients with Primary Hypertension and Coronary Artery Disease

    Institute of Scientific and Technical Information of China (English)

    CHENG Wen-li; KE Yuan-nan; SHI Zai-xiang; WANG Ying; CHEN Li; JU Gao; FAN Shu-ying

    2006-01-01

    Objective: To investigate the effect of garlicin in treating carotid artery atherosclerotic plaque (CAAP) in patients with primary hypertension and coronary heart disease (PHT-CHD). Methods: Seventynine patients with PHT-CHD were randomly divided into the treated group (39 patients) treated with garlicin and fosinopril and the control group (40 patients) treated with fosinopril alone. The change of CAAP was evaluated by high frequency ultrasonic examination every six months, and the changes of intercellular adhesion molecule-1 (ICAM-1) and high sensitive C-reactive protein (hs-CRP) were measured by ELISA, with the observation proceeding for 52 weeks totally. Results: By the end of the experiment, the number of complex plaques, Crouse integrals, intima-media thickness, serum ICAM-1 and hs-CRP were significantly lower in the treated group than those in the control group with significant difference (P<0.05). Conclusion; Garlicin could stabilize CAAP to a certain extent and shows a definite vascular protective effect in patients with PHT-CHD.

  13. [Partial infarction of the kidney caused by spontaneous idiopathic dissection of the renal artery].

    Science.gov (United States)

    Dahmani, Laurent; Murat, François-Joseph; Ouaki, Frédéric; Irani, Jacques; Dore, Bertrand

    2003-09-01

    Idiopathic spontaneous renal artery dissection (SRAD) is a rare disease and must be taken into account in the differential diagnosis of low back pain. It may be due to various aetiologies, secondary to degenerative or traumatic diseases, or it may be idiopathic. Intravenous urography is usually normal. Abdominal CT usually visualizes the renal infarction and selective arteriography confirms the diagnosis of renal artery dissection. Medical treatment and surveillance provide effective management of the disease. However, surgical management may be proposed either immediately or secondarily. SRAD usually has a favourable course, but, in the longer term, may be complicated by organic renal failure and renovascular hypertension. PMID:14650302

  14. Stent-assisted angioplasty for atherosclerotic stenosis of the carotid artery. An overview

    International Nuclear Information System (INIS)

    For symptomatic stenosis of the carotid artery the invasive options for treatment (by means of stent or operation) are superior to conservative medical treatment. Recent multi-center randomized controlled trials, which will be presented here, indicate that stenting in the treatment of symptomatic carotid stenosis is neither safer nor more effective than carotid endarterectomy. When carried out by an experienced interventionalist stent-assisted angioplasty (CAS) is an alternative to carotid endarterectomy. Subgroup-analysis indicates that for patients older than 70 years of age invasive techniques should be the method of choice. In the case of contralateral high-grade stenosis or occlusion, CAS is the method of choice. For patients treated by stenting, the periprocedural complication rate is not influenced by the use of protection systems. The present results on symptomatic carotid stenosis should not be transferred to the therapy of asymptomatic carotid stenosis. A 3-armed study (SPACE2) on the comparison of the best medical treatment with the invasive treatment modalities (CAS or CEA) is in preparation and will be started in 2 months. (orig.)

  15. Clinical observation of intraluminal stent angioplasty in the treatment of renal arterial stenoses

    International Nuclear Information System (INIS)

    Objective: To evaluate the clinical application of intraluminal stent angioplasty (PTRAS) in the treatment of renal arterial stenoses. Methods: A retrospective study was done in 28 patients with renal arterial stenoses. Primary renal artery stenting was performed in 28 consecutive patients (36 renal arteries). Blood pressure, serum creating, the number of anti-hypertensive medications were recorded at 1, 6, 12 month post stent angioplasty respectively. Arterial angiography was also taken 1 year later to evaluate the incidence of restenosis. Results: Technical success rate was 100% achieving in all patients without serious complications. Primary successful patently rate reached 82% (renal artery 86%), secondary successful rate was 89% (renal artery 90%). Systolic and diastolic blood pressure were reduced significantly (P<0.01) at 1,6,12 month after stent angioplasty comparing with baseline and clinical improvement (cured + improved) of hypertension reached 100%, 92.9%, 89.3% respectively. There were no significant differences between serum creatine level and the number of anti-hypertensive medications before and after stent angioplasty. One year later, 14.3% of all patients showed improvement of renal function, 64.3% remained in stabilization and 21.4% fell into deterioration. Angiographic restenosis was found in 3 cases one year after stent angioplasty. Complications included 1 hematoma at puncture site and 3 transient azotaemia. Conclusions: PTRAS can be performed safely with high technical success and beneficial to the majority of patients with hypertension or renal insufficiency and therefore it should be the first choice in treating renal arterial stenoses

  16. Development of chronic heart failure in a young woman with hypertension associated with renal artery stenosis with preserved renal function

    DEFF Research Database (Denmark)

    Byrne, Christina; Abdulla, Jawdat

    2014-01-01

    A 33-year-old woman with presumed essential hypertension and symptoms equivalent to New York Heart Association class II was suspected of heart failure and referred to echocardiography. The patient's ECG showed a left bundle branch block. Electrolytes, serum creatinine and estimated-glomerular fil......A 33-year-old woman with presumed essential hypertension and symptoms equivalent to New York Heart Association class II was suspected of heart failure and referred to echocardiography. The patient's ECG showed a left bundle branch block. Electrolytes, serum creatinine and estimated......-glomerular filtration rate as well as urine test for protein were all normal. The patient had no peripheral oedema. The transthoracic echocardiography confirmed systolic and diastolic dysfunction and an ejection fraction of 25% and left ventricular hypertrophy. Ultrasound of renal arteries and renal CT angiography...... (renal CTA) revealed a significant stenosis and an aneurysm corresponding to the right renal artery with challenges to traditional interventions....

  17. Selective expansion of influenza A virus-specific T cells in symptomatic human carotid artery atherosclerotic plaques

    OpenAIRE

    Keller, Tymen; Meer, Jelger; Teeling, Peter; Sluijs, Koenraad; Idu, Mirza; Rimmelzwaan, Guus; Levi, Michael; Wal, Allard; Boer, Onno

    2008-01-01

    textabstractBACKGROUND AND PURPOSE - Evidence is accumulating that infection with influenza A virus contributes to atherothrombotic disease. Vaccination against influenza decreases the risk of atherosclerotic syndromes, indicating that inflammatory mechanisms may be involved. We tested the hypothesis that influenza A virus-specific T cells contribute to atherosclerotic plaque inflammation, which mediates the onset of plaque rupture. METHODS - T-cell cultures were generated from atheroscleroti...

  18. Postpyelolithotomy Renal Artery Pseudoaneurysm Management with Percutaneous Thrombin Injection: A Case Report

    International Nuclear Information System (INIS)

    Renal artery pseudoaneurysm leading to life-threatening hematuria can occur after a surgical procedure such as pyelolithotomy, albeit rarely. With recent advances in transarterial embolization techniques, this minimally invasive procedure has become the treatment of choice, replacing surgery. We present a case of massive hematuria due to renal artery pseudoaneurysm developing after pyelolithotomy that was managed with percutaneus thrombin injection directly into the pseudoaneurysm

  19. Flash pulmonary edema in patients with renal artery stenosis--the Pickering Syndrome

    DEFF Research Database (Denmark)

    Pelta, Anna; Andersen, Ulrik B; Just, Sven;

    2010-01-01

    We report the prevalence of flash pulmonary edema in patients consecutively referred for balloon angioplasty of uni- or bilateral renal artery stenosis (PTRA), and describe the characteristics of this special fraction of the patients. We further report two unusual cases.......We report the prevalence of flash pulmonary edema in patients consecutively referred for balloon angioplasty of uni- or bilateral renal artery stenosis (PTRA), and describe the characteristics of this special fraction of the patients. We further report two unusual cases....

  20. Bilateral renal artery stenosis and pheochromocytoma an uncommon association: A case report

    Directory of Open Access Journals (Sweden)

    Muhammad Sohail Anjum

    2010-10-01

    Full Text Available Pheochromocytoma and bilateral renal artery stenosis have a quite rare association. Although unilateral renal artery stenosis is reported in the literature with Pheochromocytoma but bilateral renal artery stenosis never reported before in Gulf region. A 56-years-old woman primarily referred to our facility for CABG for triple vessel disease but uncontrolled blood pressure and long standing history of hypertension rendered her for further investigations for secondary causes. The technical imaging techniques (USG, abdominal CT, magnetic resonance angiogram (MRA revealed bilateral renal artery stenosis and left supra-adrenal mass. Further hormonal assays confirmed high catecholamine and raised rennin and aldosterone secondary to Pheochromocytoma and bilateral renal artery stenosis. Laparoscopic removal of Pheochromocytoma with minimum invasive reconstructive surgery for bilateral renal artery stenosis was planned prior to CABG for triple vessel disease but patient declined any surgery or interventional and opted for conservative management inspite of repeated counselling sessions with the patient. Although these conditions co-existed simultaneously but differ in management.

  1. Renal Artery Stenosis in a Young Female without Fibromuscular Dysplasia with Literature Review

    OpenAIRE

    Peralta, Paloma; Cholankeril, Matthew; Goldberg, Daniel; Koneru, Jayanth; Shamoon, Fayez

    2016-01-01

    Renal artery stenosis (RAS) is rare in young patients without fibromuscular dysplasia (FMD). RAS is primarily classified as having two major etiologies, namely, atherosclerosis and FMD, with 90% and 10%, respectively. We report a case of a female in her mid 20s who developed hypertension due to RAS with no evidence of FMD or underlying renal dysfunction and underwent successful angioplasty and stenting.

  2. Arterial spin labeling MR imaging for characterisation of renal masses in patients with impaired renal function: initial experience

    Energy Technology Data Exchange (ETDEWEB)

    Pedrosa, Ivan [Beth Israel Deaconess Medical Center and Harvard Medical School, Department of Radiology, Boston, MA (United States); UT Southwestern Medical Center, Department of Radiology, Dallas, TX (United States); Rafatzand, Khashayar; Robson, Philip; Alsop, David C. [Beth Israel Deaconess Medical Center and Harvard Medical School, Department of Radiology, Boston, MA (United States); Wagner, Andrew A. [Beth Israel Deaconess Medical Center and Harvard Medical School, Surgery, Division of Urology, Boston, MA (United States); Atkins, Michael B. [Beth Israel Deaconess Medical Center and Harvard Medical School, Hematology/Oncology, Boston, MA (United States); Rofsky, Neil M. [University of Texas Southwestern Medical Center, Departments of Radiology, Dallas, TX (United States)

    2012-02-15

    To retrospectively evaluate the feasibility of arterial spin labeling (ASL) magnetic resonance imaging (MRI) for the assessment of vascularity of renal masses in patients with impaired renal function. Between May 2007 and November 2008, 11/67 consecutive patients referred for MRI evaluation of a renal mass underwent unenhanced ASL-MRI due to moderate-to-severe chronic or acute renal failure. Mean blood flow in vascularised and non-vascularised lesions and the relation between blood flow and final diagnosis of malignancy were correlated with a 2-sided homogeneous variance t-test and the Fisher Exact Test, respectively. A p value <0.05 was considered statistically significant. Seventeen renal lesions were evaluated in 11 patients (8 male; mean age = 70 years) (range 57-86). The median eGFR was 24 mL/min/1.73 m{sup 2} (range 7-39). The average blood flow of 11 renal masses interpreted as ASL-positive (134 +/- 85.7 mL/100 g/min) was higher than that of 6 renal masses interpreted as ASL-negative (20.5 +/- 8.1 mL/100 g/min)(p = 0.015). ASL-positivity correlated with malignancy (n = 3) or epithelial atypia (n = 1) at histopathology or progression at follow up (n = 7). ASL detection of vascularity in renal masses in patients with impaired renal function is feasible and seems to indicate neoplasia although the technique requires further evaluation. (orig.)

  3. Prevalence of calcified carotid artery atheromas on panoramic radiographs of renal stone patients.

    Science.gov (United States)

    Patil, Santosh; Maheshwari, Sneha; Khandelwal, Suneet; Malhotra, Ritumvada; Desmukh, Anupam

    2016-01-01

    The aim of the present study was to evaluate the prevalence of calcified carotid artery atheromas detected on panoramic radiographs of patients with renal stones and to assess the correlation of renal stones and carotid artery calcifications (CAC). Panoramic radiographs of 120 renal stone patients (76 males and 44 females) and 120 controls (68 males and 52 females) were examined for any calcifications in the carotid artery. The mean age of the patients with renal stones and controls was 40.6±7.8 years and 41.1±6.7 years, respectively. A total of 25 (20.8%) patients with renal stones and 16 (12.3%) patients from the control group showed CAC. The calcifications were however higher in the patients with renal stones, but there was no statistically significant difference (P>0.05) between the two groups. CAC was found in 15 males and ten females with renal stones and nine males and seven females of the control group, and this difference was not statistically significant (P>0.05). In the present study, no significant relationship was found between the presence of CAC in the patients with renal stones and the control group. However, there was a trend for higher prevalence of CAC in renal stone patients. PMID:26787568

  4. Prevalence of calcified carotid artery atheromas on panoramic radiographs of renal stone patients

    Directory of Open Access Journals (Sweden)

    Santosh Patil

    2016-01-01

    Full Text Available The aim of the present study was to evaluate the prevalence of calcified carotid artery atheromas detected on panoramic radiographs of patients with renal stones and to assess the correlation of renal stones and carotid artery calcifications (CAC. Panoramic radiographs of 120 renal stone patients (76 males and 44 females and 120 controls (68 males and 52 females were examined for any calcifications in the carotid artery. The mean age of the patients with renal stones and controls was 40.6 ± 7.8 years and 41.1 ± 6.7 years, respectively. A total of 25 (20.8% patients with renal stones and 16 (12.3% patients from the control group showed CAC. The calcifications were however higher in the patients with renal stones, but there was no statistically significant difference (P >0.05 between the two groups. CAC was found in 15 males and ten females with renal stones and nine males and seven females of the control group, and this difference was not statistically significant (P >0.05. In the present study, no significant relationship was found between the presence of CAC in the patients with renal stones and the control group. However, there was a trend for higher prevalence of CAC in renal stone patients.

  5. Cutting-Balloon Angioplasty Versus Balloon Angioplasty as Treatment for Short Atherosclerotic Lesions in the Superficial Femoral Artery: Randomized Controlled Trial

    International Nuclear Information System (INIS)

    Purpose: To evaluate the treatments of a short-segment atherosclerotic stenosis in the superficial femoral arteries with the cutting balloon angioplasty (CBA) versus conventional balloon angioplasty [percutaneous transluminal angioplasty (PTA)] in a randomized controlled trial. Material and Methods: The study group comprised 60 patients (33 men, 27 women; average age 64 years) with a short (≤5 cm) focal SFA de novo atherosclerotic stenosis associated with a history of intermittent claudication or rest pain. The primary end point of this study was the rate of binary restenosis in the treated segment 12 months after the intervention. All patients were evenly randomized to either the PTA or CBA treatment arms. Follow-up angiograms and ankle–brachial index (ABI) measurements were performed after 12 months. The evaluation of the restenosis rates and factors influencing its occurrence were calculated by logistic regression analysis. Results: In the intention-to-treat analysis, restenosis rates after 2-month follow-up were 9 of 30 (30 %) in the PTA group and 4 of 30 (13 %) in the CBA group (p = 0.117). In the actual treatment analysis, after exclusion of patients who required nitinol stent placement for a suboptimal result after angioplasty alone (5 patients in the PTA group and none in the CBA group), restenosis rates were 9 of 25 (36 %) and 4 of 30 (13 %), respectively (p = 0.049). In the intention-to-treat analysis there were also significant differences in ABI values between the PTA and CBA groups at 0.77 ± 0.11 versus 0.82 ± 0.12, respectively (p = 0.039), at 12 months. Conclusion: Based on the presented results of the trial, CBA seems to be a safer and more effective than PTA for treatment of short atherosclerotic lesions in the superior femoral artery

  6. Cutting-Balloon Angioplasty Versus Balloon Angioplasty as Treatment for Short Atherosclerotic Lesions in the Superficial Femoral Artery: Randomized Controlled Trial

    Energy Technology Data Exchange (ETDEWEB)

    Poncyljusz, Wojciech, E-mail: wponcyl@poczta.onet.pl; Falkowski, Aleksander, E-mail: bakhis@hot.pl [Pomeranian Medical University, Department of Interventional Radiology (Poland); Safranow, Krzysztof, E-mail: chrissaf@mp.pl; Rac, Monika, E-mail: carmon@pum.edu.pl [Pomeranian Medical University, Department of Biochemistry and Medical Chemistry (Poland); Zawierucha, Dariusz, E-mail: dariusz13@yahoo.com [Interventional Radiology, Sacred Heart Medical Center, River Bend (United States)

    2013-12-15

    Purpose: To evaluate the treatments of a short-segment atherosclerotic stenosis in the superficial femoral arteries with the cutting balloon angioplasty (CBA) versus conventional balloon angioplasty [percutaneous transluminal angioplasty (PTA)] in a randomized controlled trial. Material and Methods: The study group comprised 60 patients (33 men, 27 women; average age 64 years) with a short ({<=}5 cm) focal SFA de novo atherosclerotic stenosis associated with a history of intermittent claudication or rest pain. The primary end point of this study was the rate of binary restenosis in the treated segment 12 months after the intervention. All patients were evenly randomized to either the PTA or CBA treatment arms. Follow-up angiograms and ankle-brachial index (ABI) measurements were performed after 12 months. The evaluation of the restenosis rates and factors influencing its occurrence were calculated by logistic regression analysis. Results: In the intention-to-treat analysis, restenosis rates after 2-month follow-up were 9 of 30 (30 %) in the PTA group and 4 of 30 (13 %) in the CBA group (p = 0.117). In the actual treatment analysis, after exclusion of patients who required nitinol stent placement for a suboptimal result after angioplasty alone (5 patients in the PTA group and none in the CBA group), restenosis rates were 9 of 25 (36 %) and 4 of 30 (13 %), respectively (p = 0.049). In the intention-to-treat analysis there were also significant differences in ABI values between the PTA and CBA groups at 0.77 {+-} 0.11 versus 0.82 {+-} 0.12, respectively (p = 0.039), at 12 months. Conclusion: Based on the presented results of the trial, CBA seems to be a safer and more effective than PTA for treatment of short atherosclerotic lesions in the superior femoral artery.

  7. Angioplasty in patients with vertebrobasilarintracranial atherosclerotic stenosis and stenting of the vertebral artery ostium: results from a single center experience

    International Nuclear Information System (INIS)

    Full text: Medical therapy in patients with TIA or stroke in the vertebrobasilar system (VBS) is not always optimal to change the natural history of the disease. Alternative treatment includes endovascular angioplasty with and without stenting. The purpose of the study was to report the results from angiography and clinical outcome in a small cohort of patients with VBS pathology who underwent angioplasty and/or stenting. Fourteen patients (mean age of 60.5 ±8.4 years) were treated. All patients underwent digital subtractive cerebral angiography to find a stenosis that met criteria for endovascular therapy. Neuroimaging before procedure included angio-CT/MRI. extra and transcranial colour duplex scanning was used for hemodynamic evaluation of the stenosis and recanalization before, and 1 year after the treatment. Clinical outcome according to modified Rankin Scale (mRS) and mortality were assessed on day 90 and one year after the treatment. Standard medical treatment was given to all patients. Results: TIA had 9 patients, and previous stroke had 8 patients.Left vertebral artery (VA) was affected in 6 patients, right in 8 patients. Tandem VS stenoses had 1 patient (ostium and VA4-segment). Contralateral VA thrombosis was found in 4 patients and a hypoplastic VA in 1. Mean degree of VBS stenosis in all patients was 87.5 ±7.2%. Successful balloon angioplasty of the intracranial AV4 stenosis was achieved in 3 patients, however not in one other with a severe basilar artery stenosis. Eight patients with extracranial atherosclerotic stenosis of the ostium (VAO) and 1 with right VA1 dissection received stents with excellent angiogpahic results. Balloon predialtation was achieved with mean pressure of 10.8 ±2.8 mm Hg.The mean length of the stents was 18.3 ±11.2 mm, with mean diameter 4.2 mm. Types of stents used were: 1 Pulsar, 1 Integrity, 2 orsiro, 1 CristalloIdeale, 1 energy, and 3 drug eluding stents endeavor Resolute. Mean scopia time was 8.5 ±8 minutes, and mean

  8. Lumen segmentation and motion estimation in B-mode and contrast-enhanced ultrasound images of the carotid artery in patients with atherosclerotic plaque.

    Science.gov (United States)

    Carvalho, Diego D B; Akkus, Zeynettin; van den Oord, Stijn C H; Schinkel, Arend F L; van der Steen, Antonius F W; Niessen, Wiro J; Bosch, Johan G; Klein, Stefan

    2015-04-01

    In standard B-mode ultrasound (BMUS), segmentation of the lumen of atherosclerotic carotid arteries and studying the lumen geometry over time are difficult owing to irregular lumen shapes, noise, artifacts, and echolucent plaques. Contrast enhanced ultrasound (CEUS) improves lumen visualization, but lumen segmentation remains challenging owing to varying intensities, CEUS-specific artifacts and lack of tissue visualization. To overcome these challenges, we propose a novel method using simultaneously acquired BMUS&CEUS image sequences. Initially, the method estimates nonrigid motion (NME) from the image sequences, using intensity-based image registration. The motion-compensated image sequence is then averaged to obtain a single "epitome" image with improved signal-to-noise ratio. The lumen is segmented from the epitome image through an intensity joint-histogram classification and a graph-based segmentation. NME was validated by comparing displacements with manual annotations in 11 carotids. The average root mean square error (RMSE) was 112±73 μm . Segmentation results were validated against manual delineations in the epitome images of two different datasets, respectively containing 11 (RMSE 191±43 μm) and 10 (RMSE 351±176 μm ) carotids. From the deformation fields, we derived arterial distensibility with values comparable to the literature. The average errors in all experiments were in the inter-observer variability range. To the best of our knowledge, this is the first study exploiting combined BMUS&CEUS images for atherosclerotic carotid lumen segmentation. PMID:25423650

  9. Rupture of the Renal Artery After Cutting Balloon Angioplasty in a Young Woman With Fibromuscular Dysplasia

    International Nuclear Information System (INIS)

    A 24-year-old woman with uncontrollable high blood pressure for 3 months had significant stenosis of the left renal artery caused by fibromuscular dysplasia (FMD). The lesion was resistant to percutaneous transluminal angioplasty at 18 atm with a semicompliant balloon. Angioplasy with a 6 x 10 mm cutting balloon (CB) caused rupture of the artery. Low-pressure balloon inflation decreased but did not stop the leak. An attempt to place a stent-graft (Jostent; Jomed, Rangendingen, Germany) failed, and a bare, 6-mm balloon-expandable stent (Express SD; Boston Scientific, MN) was deployed to seal the leak, which had decreased considerably after long-duration balloon inflation. The bleeding continued, and the patient underwent emergent surgical revascularization of the renal artery with successful placement of a 6-mm polytetrafluoroethylene bypass graft. CBs should be used very carefully in the treatment of renal artery stenosis, particularly in patients with FMD

  10. Diagnostic role of new Doppler index in assessment of renal artery stenosis

    Directory of Open Access Journals (Sweden)

    Herrera Ramón N

    2006-01-01

    Full Text Available Abstract Background Renal artery stenosis (RAS is one of the main causes of secondary systemic arterial hypertension. Several non-invasive diagnostic methods for RAS have been used in hypertensive patients, such as color Doppler ultrasound (US. The aim of this study was to assess the sensitivity and specificity of a new renal Doppler US direct-method parameter: the renal-renal ratio (RRR, and compare with the sensitivity and specificity of direct-method conventional parameters: renal peak systolic velocity (RPSV and renal aortic ratio (RAR, for the diagnosis of severe RAS. Methods Our study group included 34 patients with severe arterial hypertension (21 males and 13 females, mean age 54 (± 8.92 years old consecutively evaluated by renal color Doppler ultrasound (US for significant RAS diagnosis. All of them underwent digital subtraction arteriography (DSA. RAS was significant if a diameter reduction > 50% was found. The parameters measured were: RPSV, RAR and RRR. The RRR was defined as the ratio between RPSV at the proximal or mid segment of the renal artery and RPSV measured at the distal segment of the renal artery. The sensitivity and specificity cutoff for the new RRR was calculated and compared with the sensitivity and specificity of RPSV and RAR. Results The accuracy of the direct method parameters for significant RAS were: RPSV >200 cm/s with 97% sensitivity, 72% specificity, 81% positive predictive value and 95% negative predictive value; RAR >3 with 77% sensitivity, 90% specificity, 90% positive predictive value and 76% negative predictive value. The optimal sensitivity and specificity cutoff for the new RRR was >2.7 with 97% sensitivity (p Conclusion The new RRR has improved specificity compared with the direct method conventional parameters (RPSV >200cm/s and RAR >3. Both RRR and RPSV show better sensitivity than RAR for the RAS diagnosis.

  11. RX Herculink Elite® renal stent system: a review of its use for the treatment of renal artery stenosis

    Directory of Open Access Journals (Sweden)

    Colyer Jr

    2012-08-01

    Full Text Available William R Colyer JrDivision of Cardiovascular Medicine, University of Toledo Medical Center, Toledo, OH, USAAbstract: The management of renal artery stenosis (RAS remains controversial. While some evidence suggests that treatment with stent placement is beneficial, randomized trials have failed to demonstrate a significant benefit. Ongoing clinical trials should help to better define the role for stenting of RAS while avoiding limitations seen with earlier trials. When it comes to stenting for RAS, several stents have been used; however, many stents which have been used previously and which are still being used are biliary stents that are used “off-label.” These stents have typically come onto the market through the 510(k pathway. To date, a total of five stents have been approved by the United States Food and Drug Administration for use in the renal arteries. Of the five stents that have received approval, the Bridge™ Extra Support (Medtronic CardioVascular, Santa Rosa, CA and the Palmaz® (Cordis Corporation, Bridgewater, NJ stents are no longer available. Currently, the Express® SD (Boston Scientific, Natick, MA, Formula™ (Cook Medical, Bloomington, IN, and Herculink Elite® (Abbott Vascular, Santa Clara, CA stents are Food and Drug Administration approved and available for use. The Herculink Elite is the most recently approved of the renal stents, having received approval in late 2011. The Herculink Elite stent is the only cobalt chromium stent approved for use in the renal arteries. Although trial data are limited and direct comparisons among renal stents is not possible, the Herculink Elite stent has demonstrated good performance. Additionally, the design of the Herculink Elite offers some advantages that may translate into improved outcomes.Keywords: renal artery stenosis, stenting, FDA approval

  12. Fetal development of the mesonephric artery in humans with reference to replacement by the adrenal and renal arteries.

    Science.gov (United States)

    Hinata, Nobuyuki; Suzuki, Ryoji; Ishizawa, Akimitsu; Miyake, Hideaki; Rodriguez-Vazquez, Jose Francisco; Murakami, Gen; Fujisawa, Masato

    2015-11-01

    According to the classical ladder theory, the mesonephric arteries (MAs) have a segmental arrangement and persist after regression of the mesonephros, with some of these vessels becoming definitive renal arteries. To avoid interruption of blood flow, such a vascular switching would require an intermediate stage in which two or more segmental MAs are connected to a definitive renal artery. To examine developmental changes, especially changes in the segmental distribution of MAs, we studied serial paraffin sections of 26 human embryos (approximately 5-7 weeks). At 5-6 weeks, 1-2 pairs of MAs ran anterolaterally or laterally within each of the lower thoracic vertebral segments, while 2-5 pairs of MAs were present in each of the lumbar vertebral segments, but they were usually asymmetrical. The initial metanephros, extending along the aorta from the first lumbar to first sacral vertebra, had no arterial supply despite the presence of multiple MAs running immediately anterior to it. Depending on increased sizes of the adrenal and metanephros, the MAs were reduced in number and restricted in levels from the twelfth thoracic to the second lumbar vertebra. The elimination of MAs first became evident at a level of the major, inferior parts of the metanephros. Therefore, a hypothetical arterial ladder was lost before development of glomeruli in the metanephros. At 7 weeks, after complete elimination of MAs, a pair of symmetrical renal arteries appeared near the superior end of the metanephros. In conclusion, the MAs appear not to persist to become a definitive renal artery. PMID:26335195

  13. Congenital solitary kidney with multiple renal arteries: case report using MDCT angiography.

    Science.gov (United States)

    Matusz, Petru; Miclăuş, Graţian Dragoslav; Banciu, Christian Dragoş; Sas, Ioan; Joseph, Shamfa C; Pirtea, Laurenţiu Cornel; Tubbs, R Shane; Loukas, Marios

    2015-01-01

    A congenital solitary kidney with multiple renal arteries is a rare congenital abnormality that can occur in the presence of multiple other anomalies. We describe an atypical case of a right congenital solitary kidney with three renal arteries (RA) one main RA and two additional renal arteries in a 75-year-old woman with uterine didelphys. The main RA had an intraluminal diameter larger than the diameter of the additional renal arteries (AdRAs) at the origin (0.53 cm for the main RA; 0.49 cm and 0.32 cm for the two AdRAs). Both the AdRAs had a greater length than the main RA (3.51 cm for the main RA; 3.70 cm and 4.77 cm for the two AdRAs). The calculated volume of the kidney was 283 cm³, while the volume of the renal parenchyma was 258 cm³. Knowledge of this variant is extremely important in clinical practice as it has been found to be associated with proteinuria, hypertension and renal insufficiency. PMID:26429179

  14. Renal Angioplasty in Non-atheromatous Renal Artery Stenosis: Technical Results and Clinical Outcome in 43 Patients

    International Nuclear Information System (INIS)

    This study retrospectively reviewed the technical and clinical results of percutaneous transluminal renal artery angioplasty (PTRA) for non-atheromatous renal artery stenosis (RAS) in a Tertiary Renal Referral Centre. Forty-three patients (including 9 children) underwent 49 PTRA procedures for stenoses of 63 arteries over the period 1984-2001 (14 patients had bilateral stenosis treated during one procedure. There were 29 females and 14 males (age range 1-72 years, median 37 years). The etiology of the RAS was classical beaded FMD (medial fibroplasia) in 24, atypical or 'variant FMD' with a more focal stenosis (intimal fibroplasia) in 11, neurofibromatosis type 1 (NF) in 7 and Takayasu's Arteritis in 1. Five of the NF patients had angioplasty for stenoses following vascular repair procedures. A technically good result was obtained in 34/34 arteries with 'classical' RAS, 9/13 atypical arteries, 11/15 arteries of NF patients and in the one Takayasu's case. Clinical follow-up for a mean of 16 months revealed a cure rate of hypertension in classical FMD of 35% with improvement in a further 55%. In the atypical FMD cases, follow-up was obtained on 6 patients with 2 cures and the other 4 demonstrating benefit. There was a better chance of cure in younger patients. In native artery PTRA in children with NF, only 1 out of 3 patients was 'cured' post-PTRA, and 2 out of 3 failed. However, in postsurgical stenoses in NF patients 1 out of 4 patients was 'cured' and 3 out of 4 improved. In conclusion, classical FMD responds well to PTRA with better results in younger patients. Atypical FMD, especially in children and when associated with NF, is less predictable. Stenoses consequent to revascularization surgery respond well to PTRA

  15. Evaluation of blood flow in Allograft Renal Arteries anastomosed with two different techniques

    International Nuclear Information System (INIS)

    Renal artery stenosis in renal transplantation (TRAS) is an avoidable short or long term surgical complication. The etiology is multifactorial, but faulty anastomosis is a major factor. In our transplant center, we evaluated the incidence of TRAS with the use of two different suturing techniques of the anastomosis site between allograft renal and renal and iliac arteries in two groups of renal transplant recipients, group A: 14 patients (6 males and 8 females with age 16 to 59 and mean age of 38 years) in whom allograft arteries were anastomosed with a continuous suture technique and group B: 14 patients (7 males and 7 females with age 32 to 61 and mean age of 46.6 years) in whom the allograft arteries were anastomosed with a combined suture technique (continuous and uninterrupted. Post transplantation, the velocity of blood flow in the renal and iliac arteries at the site of anastomosis was measured by color Doppler ultrasound. The ultrasonographer was blinded to the surgical technique in both study groups. The ratio of the maximum velocity of blood at the site of anastomosis to that in the iliac artery of less than 2.5 was considered as non-significant stenosis, while a ratio of more than 2.5 was considered significant stenosis. In group A there were 9 cases of non-significant stenosis in comparison to 3 cases in group B, while there were no cases of significant stenosis in group A in comparison to 3 cases in group B; the difference was not statistically significant. We conclude that there was no difference in the compared surgical techniques of anastomosis in our study groups. This suggests that other factors such as gentle handling of tissue, enough spatula, margin reversion and comparable diameter of the anastomosed vessels may be more important in the prevention of renal allograft stenosis than the type of suture technique. (author)

  16. Evaluation of the renal venous system on late arterial and venous phase images with MDCT angiography in potential living laparoscopic renal donors

    Energy Technology Data Exchange (ETDEWEB)

    Kawamoto, S.; Lawler, L.P.; Fishman, E.K. [Johns Hopkins Hospital, Baltimore, MD (United States). The Russell H. Morgan Department of Radiology and Radiological Science

    2005-03-15

    Objective: The objective of our study was to assess whether both renal arteries and renal veins can be evaluated using single-phase MDCT data sets alone to eliminate the need for both arterial and venous phase data sets. Materials and methods: One hundred consecutive potential living renal donors who underwent 4- MDCT were evaluated. CT was performed with 120 mL of IV contrast material at an injection rate of 3 mL/sec. Both late arterial and venous phase acquisitions were obtained at 25 and 55 sec from the start of IV contrast injection, respectively. The number of the right and left renal veins and its anatomic variations were assessed by two reviewers. Late arterial phase images were evaluated initially, and then venous phase images were analyzed to assess opacification of the renal vein and to see whether venous phase data sets changed or added information about the venous anatomy as seen on late arterial phase images. Results: The retroaortic left renal vein was found in two subjects, and the circumaortic left renal vein was detected in three subjects. The renal veins were adequately opacified on late arterial phase images in all subjects. There were six subjects who had a normal left renal vein with a small posterior branch coursing posterior to the aorta and draining into the inferior vena cava, which were difficult to differentiate from the lumbar vein or ascending lumbar vein; in three of these six subjects, the small posterior branch was opacified only on venous phase images. Conclusion: Late arterial phase images obtained at 25 sec after the start of contrast injection can reveal the renal vein anatomy except for a small posterior branch of the left renal vein difficult to differentiate from the lumbar or ascending lumbar vein, as seen in three subjects. The data suggest that venous phase imaging is not necessary for the evaluation of renal vein anatomy. (author)

  17. A reversible bilateral renal artery stenosis in association with antiphospholipid syndrome.

    Science.gov (United States)

    Remondino, G I; Mysler, E; Pissano, M N; Furattini, M C; Basta, M C; Presas, J L; Allievi, A

    2000-01-01

    We describe a 26-year-old white female with a history of Raynaud phenomenon, erythema nodosum, polyarthralgias, migraine, vertigo, seizures, transient ischemic attacks, one fetal loss, and false positive VDRL, who developed milk hypertension without overt lupus nephritis. She had positive antinuclear antibodies (ANA) and double-stranded deoxyribonucleic acid (dsDNA) antibodies. The lupus anticoagulant test (LAC) and cardiolipins antibodies (aCL) were positive. She was diagnosed as having a Systemic Lupus Erythematosus-like illness (SLE-like) with 'secondary' antiphospholipid syndrome (APS). Renal spiral computed tomography (CT) with intravenous (IV) contrast showed bilateral renal artery stenosis. Anticoagulation with acenocumarol was started. She became normotensive without antihypertensive drugs five months later. A follow-up renal spiral CT showed complete recanalization of both renal arteries, making thrombosis the more likely culprit pathology in the stenosis. After two years follow up the patient is normotensive. She remains on acenocumarol. PMID:10713649

  18. An experience with placement of a stent-graft in a renal artery aneurysm via the brachial artery: a case report

    Energy Technology Data Exchange (ETDEWEB)

    Park, Mi Hyun; Shin, Byung Seok; Ahn, Moon Sang [Chungnam National University Hospital, Daejeon (Korea, Republic of)

    2005-12-15

    We introduce here our case of a 4-cm, large saccular aneurysm in a patient with right flank pain that was treated by placement of a stent-graft via the left brachial artery. The large renal artery aneurysm was successfully occluded without any permanent sequela, although there were several complications that included intraprocedural renal arterial thrombosis, occlusion of the posterior segmental artery, a small thromboembolism in the left pons and a small arteriovenous fistula in the brachial artery. Stent-graft placement for treatment of renal arterial aneurysm is an effective and safe procedure, but the operator has to be cautious not to induce complications in case of using the brachial arterial approach.

  19. The Role of Dermcidin Isoform 2: A Two-Faceted Atherosclerotic Risk Factor for Coronary Artery Disease and the Effect of Acetyl Salicylic Acid on It

    Directory of Open Access Journals (Sweden)

    Rajeshwary Ghosh

    2012-01-01

    Full Text Available Hypertension and diabetes mellitus are considered to be two major atherosclerotic risk factors for coronary artery disease (CAD. A stress-induced protein identified to be dermcidin isoform 2 of Mr. 11 kDa from blood plasma of hypertensive persons when injected (0.1 μM in rabbits increased the systolic pressure by 77% and diastolic pressure by 45% over the controls within 2 h. Ingestion of acetyl salicylic acid (150 mg/70 kg by these subjects reduced systolic (130 mm Hg and diastolic pressures (80 mm Hg with reduction of plasma dermcidin level to normal ranges (9 nM. The protein was found to be a potent activator of platelet cyclooxygenase and inhibited insulin synthesis. Aspirin was found to reduce hypertension by reduction of plasma dermcidin level, neutralized the effect of cyclooxygenase, and restored the pancreatic insulin synthesis through NO synthesis. These results indicated that dermcidin could be a novel atherosclerotic risk factor for its hypertensive and diabetogenic effects.

  20. Short-Term Effects of Ankaferd Hemostat for Renal Artery Embolization: An Experimental Study

    International Nuclear Information System (INIS)

    Renal artery embolization (RAE) is a minimally invasive therapeutic technique that is utilized in a number of disorders. Ankaferd is a novel hemostatic agent with a new mechanism of action independent of clotting factors. We used Ankaferd for RAE in a sheep model. Seven adult female sheep were included in the study. Selective renal arteriogram using 5-F diagnostic catheter was performed to make sure that each kidney was fed by a single renal artery and the animal had normal renal vasculature. Coaxial 2.7-F microcatheter was advanced to the distal main renal artery. Under fluoroscopic guidance, 2 mL of Ankaferd mixed with 2 mL of nonionic iodinated contrast agent was slowly injected. Fluoroscopy was used to observe the deceleration of flow and stagnation. Control renal angiograms were performed just after embolization. After the procedure, the animals were observed for 1 day and then sacrificed with intravenous sodium thiopental. The technical success was observed in seven of the seven animals.. After embolization procedure, none of the animals died or experienced a major systemic adverse event. On macroscopic examination of the embolized kidneys, thrombus at the level of main renal artery formed after Ankaferd embolization was more compact compared with the thrombi that was not Ankaferd-associated, which was observed elsewhere. Microscopically, majority of the renal tubular cells (80–90 %) were necrotic, and there was epithelial cell damage in a small portion of the cells (10–20 %). RAE was safe and effective in the short-term with Ankaferd in studied animals. Further studies should be conducted to better delineate the embolizing potential of this novel hemostatic agent.

  1. Spontaneous Treatment of Renal Artery Pseudoaneurysm after Partial Nephrectomy: A Case Report

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Yeo Eun; Oh, Young Taik; Yang, Seung Choul; Lee, Do Yun [Severance Hospital, Yonsei University College of Medicine, Seoul (Korea, Republic of)

    2011-12-15

    A partial nephrectomy is being used increasingly for the removal of renal cell carcinomas. A renal artery pseudoaneurysm (RAP) is a rare, potentially life threatening complication after a partial nephrectomy. This paper presents a case of spontaneous thrombosis of RAP after a partial nephrectomy. The presented case is believed to be the largest in diameter (59 mm) among the reported cases of spontaneous treatment of RAP by complete thrombosis

  2. Impaired renal function impacts negatively on vascular stiffness in patients with coronary artery disease

    OpenAIRE

    Rossi, Sabrina H.; McQuarrie, Emily P.; Miller, William H.; Mackenzie, Ruth M; Dymott, Jane A.; Moreno, María U.; Taurino, Chiara; Miller, Ashley M.; Neisius, Ulf; Berg, Geoffrey A.; Valuckiene, Zivile; Hannay, Jonathan A; Dominiczak, Anna F.; Delles, Christian

    2013-01-01

    Background Chronic kidney disease (CKD) and coronary artery disease (CAD) are independently associated with increased vascular stiffness. We examined whether renal function contributes to vascular stiffness independently of CAD status. Methods We studied 160 patients with CAD and 169 subjects without CAD. The 4-variable MDRD formula was used to estimate glomerular filtration rate (eGFR); impaired renal function was defined as eGFR <60 mL/min. Carotid-femoral pulse wave velocity ...

  3. Prevalence of carotid artery calcification on panoramic radiographs in patients with renal stones

    OpenAIRE

    ÜSTÜN, İhsan; İNCİ, Mehmet; DEMİRTAŞ, ABDULLAH; ŞİŞMAN, Yıldıray; Gökçe, Cumali; ERTAŞ, Elif TARIM

    2013-01-01

    To determine the prevalence of carotid artery calcification (CAC) detected in routine dental radiography (PRs) in patients with kidney stones (KSs) and to investigate the relationship between CAC-atherosclerosis and KSs. Materials and methods: A total of 108 patients with renal stones were included in the present study. A history of renal colic, with confirmed hematuria and voiding of the calculus, radiographic evidence of KSs, or previous surgical and endoscopic removal of KSs, was used to ...

  4. Short-Term Effects of Ankaferd Hemostat for Renal Artery Embolization: An Experimental Study

    Energy Technology Data Exchange (ETDEWEB)

    Ozbek, Orhan, E-mail: orhan.ozbek@gmail.com [Selcuk University, Department of Radiology, Meram School of Medicine (Turkey); Acar, Kadir [Selcuk University, Division of Hematology, Department of Internal Medicine, Meram School of Medicine (Turkey); Koc, Osman [Selcuk University, Department of Radiology, Meram School of Medicine (Turkey); Saritas, Kadir [Afyon Kocatepe University, Department of General Surgery, Veterinary Faculty (Turkey); Toy, Hatice [Selcuk University, Department of Pathology, Meram School of Medicine (Turkey); Solak, Yalcin [Selcuk University, Division of Nephrology, Department of Internal Medicine, Meram School of Medicine (Turkey); Ozbek, Seda [Selcuk University, Department of Radiology, Selcuklu School of Medicine (Turkey); Kucukapan, Ahmet; Guler, Ibrahim [Selcuk University, Department of Radiology, Meram School of Medicine (Turkey); Gaipov, Abduzhappar; Turk, Suleyman [Selcuk University, Division of Nephrology, Department of Internal Medicine, Meram School of Medicine (Turkey); Haznedaroglu, Ibrahim Celaleddin [Hacettepe University, Division of Hematology, Department of Internal Medicine, Faculty of Medicine (Turkey)

    2013-04-15

    Renal artery embolization (RAE) is a minimally invasive therapeutic technique that is utilized in a number of disorders. Ankaferd is a novel hemostatic agent with a new mechanism of action independent of clotting factors. We used Ankaferd for RAE in a sheep model. Seven adult female sheep were included in the study. Selective renal arteriogram using 5-F diagnostic catheter was performed to make sure that each kidney was fed by a single renal artery and the animal had normal renal vasculature. Coaxial 2.7-F microcatheter was advanced to the distal main renal artery. Under fluoroscopic guidance, 2 mL of Ankaferd mixed with 2 mL of nonionic iodinated contrast agent was slowly injected. Fluoroscopy was used to observe the deceleration of flow and stagnation. Control renal angiograms were performed just after embolization. After the procedure, the animals were observed for 1 day and then sacrificed with intravenous sodium thiopental. The technical success was observed in seven of the seven animals.. After embolization procedure, none of the animals died or experienced a major systemic adverse event. On macroscopic examination of the embolized kidneys, thrombus at the level of main renal artery formed after Ankaferd embolization was more compact compared with the thrombi that was not Ankaferd-associated, which was observed elsewhere. Microscopically, majority of the renal tubular cells (80-90 %) were necrotic, and there was epithelial cell damage in a small portion of the cells (10-20 %). RAE was safe and effective in the short-term with Ankaferd in studied animals. Further studies should be conducted to better delineate the embolizing potential of this novel hemostatic agent.

  5. Renal Artery Stenosis in a Young Female without Fibromuscular Dysplasia with Literature Review

    Science.gov (United States)

    Peralta, Paloma; Cholankeril, Matthew; Goldberg, Daniel; Koneru, Jayanth; Shamoon, Fayez

    2016-01-01

    Renal artery stenosis (RAS) is rare in young patients without fibromuscular dysplasia (FMD). RAS is primarily classified as having two major etiologies, namely, atherosclerosis and FMD, with 90% and 10%, respectively. We report a case of a female in her mid 20s who developed hypertension due to RAS with no evidence of FMD or underlying renal dysfunction and underwent successful angioplasty and stenting. PMID:27398034

  6. [Endovascular radiofrequency denervation of renal arteries as an innovation method of treatment of refractory arterial hypertension. First experience in Russia].

    Science.gov (United States)

    Danilov, N M; Matchin, Iu G; Chazova, I E

    2012-01-01

    Excessive activation of the sympathetic nervous system forms the basis of pathogenesis of essential arterial hypertension (AH). The present work was aimed at evaluating efficacy and safety of endovascular radiofrequency denervation of renal arteries in patients with AH refractory AH based on the initial first experience in with using this methodology in the Russian Federation. The interventions were carried out on December 14-15th, 2011 in the first five patients presenting with AH refractory to antihypertensive therapy consisting of three and more drugs in therapeutic doses, one of which was a diuretic. The selection criteria were systolic arterial pressure (SAP) ≥160 mm Hg or ≥150 mm Hg in the presence of type 2 diabetes mellitus. The obligatory conditions for selection were the preserved renal function [glomerular filtration rate (GFR) ≥45 ml/min] and the absence of the secondary form of AH. The procedure of denervation was performed in the conditions of roentgen-operating room using special Medtronic Ardian Simplicity Catheter System™. In all cases we managed to perform bilateral denervation of renal arteries with the radiofrequency effect in not less than 4 zones of each of vessels. Efficacy of each of the effect was registered with due regard for reaching certain temperature and values of impedance. The interventions were not accompanied by the development of any complications either in the area of manipulations or the site of puncture. Neither were there any complications from the side of the cardiovascular or excretory systems of the body. Diurnal monitoring of AP (DMAP) registered a significant decrease in SAP averagely from 174±12 to 145±10 mm Hg three days after the intervention. A persistent antihypertensive effect was confirmed by the DMAP findings one month after denervation - the SAP level averagely amounted to 131±6 mm Hg. Endovascular radiofrequency denervation of renal arteries is a safe and efficient method of treatment of AH resistant

  7. An Update on Renal Artery Denervation and Its Clinical Impact on Hypertensive Disease

    Directory of Open Access Journals (Sweden)

    Aditya Bhat

    2015-01-01

    Full Text Available Hypertension is a globally prevalent condition, with a heavy clinical and economic burden. It is the predominant risk factor for premature cardiovascular and cerebrovascular disease, and is associated with a variety of clinical disorders including stroke, congestive cardiac failure, ischaemic heart disease, chronic renal failure, and peripheral arterial disease. A significant subset of hypertensive patients have resistant hypertensive disease. In this group of patients, catheter-based renal artery denervation has emerged as a potential therapy, with favourable clinical efficacy and safety in early trials. Additional benefits of this therapy are also being identified and include effects on left ventricular remodeling, cardiac performance, and symptom status in congestive cardiac failure. Utility of renal denervation for the management of resistant hypertension, however, has become controversial since the release of the Symplicity HTN-3 trial, the first large-scale blinded randomised study investigating the efficacy and safety of renal artery denervation. The aim of this paper is to evaluate the history, utility, and clinical efficacy of renal artery denervation technology, including an in-depth appraisal of the current literature and principal trials.

  8. Effects of ginsenosides on vascular reactivity in rat cerebral and renal arteries

    Institute of Scientific and Technical Information of China (English)

    WONG Wing-tak; LEUNG Fung-ping; YUNG Lai-hang; TIAN Xiao-yu; WONG Ricky Ngok Shun; HUANG Yu

    2008-01-01

    Objective To investigate possible mechanisms underlying the antioxidant property (1) and the in vitro vasodilator effects (2) of the two ginsenosides, Rb1 and Rg1, in isolated rat renal and cerebral arteries. Methods Arterial rings were mounted in a multi-channel myograph for recording of isometric tension. To examine the antioxidant activity, some rings were exposed to a free radical-generating reaction (hypoxan-thine and xanthine oxidase) with and without pre-treatment with ginsenosides. The calcium antagonistic effects were tested on rings contracted by membrane depolarization in elevated extracellular potassium ions, a condition that promoted Ca2+ influx in vascular smooth muscle cells. Results Ginsenosides protected endothelial function (endothelial nitric oxide-dependent relaxation) against oxidative stress; (2) ginsenoside Rb1 reduced the high K+ -induced contractions of both renal and cerebral arteries while ginsenoside Rgl relaxed the rat cerebral artery but not the renal artery. Conclusions Ginsenosides are vaso-protective via (1) the antioxidant activity which protects endothelial cell function and (2) the inhibition of Ca2+ influx through voltage-sensitive Ca2+ channels in vascular smooth muscle. The vasodilator effects may suggest the potential preventive or therapeutic values of ginsenosides against stroke and renal hypertension.

  9. To Stent or Not to Stent? Update on Revascularization for Atherosclerotic Renovascular Disease.

    Science.gov (United States)

    Noory, Elias; Sritharan, Kaji; Zeller, Thomas

    2016-06-01

    Renal artery stenosis (RAS) is increasingly encountered in clinical practice. The two most common etiologies are fibromuscular dysplasia (FMD) and atherosclerotic renal artery disease (ARAS), with the latter accounting for the vast majority of cases. Significant RAS activates the renin-angiotensin-aldosterone system and is associated with three major clinical syndromes: ischemic nephropathy, hypertension, and destabilizing cardiac syndromes. Over the past two decades, advancements in diagnostic and interventional techniques have led to improved detection and the widespread use of endovascular renal artery revascularization strategies in the management of ARAS. However, renal artery stenting for ARAS remains controversial. Although several studies have demonstrated some benefit with renal artery revascularization, this has not been to the extent anticipated or predicted. Moreover, these trials have significant flaws in their study design and are hampered with inherent bias which make their interpretation challenging. In this review, we evaluate the existing body of evidence and offer an approach to the management of patients with ARAS in light of the current literature. From the data provided, identification of subgroup of patients, namely, those with a hemodynamically significant RAS in the context of progressive renal insufficiency and/or deteriorating arterial hypertension, seems possible and may derive clinical benefit from ARAS stent revascularization. Appropriate patient selection is therefore the key and more robust studies are required. PMID:27130448

  10. The arcuate artery in renal transplants: An insensitive indicator of rejection

    International Nuclear Information System (INIS)

    The authors performed 65 duplex US examinations in 28 patients within 2 years of transplantation. During this time 15 episodes of rejection were diagnosed by US and confirmed clinically. Of the remaining 50 examinations, 14 showed negligible or absent diastolic flow (suggesting rejection) in the arcuate arteries with normal diastolic flow in the main renal, segmental, and interlobar branches. No other criteria for rejection were present in these patients. It is concluded that the arcuate artery is an insensitive indicator of transplant rejection

  11. Correlation of dental pulp stones, carotid artery and renal calcifications using digital panoramic radiography and ultrasonography

    OpenAIRE

    Garima Yeluri; C Anand Kumar; Namita Raghav

    2015-01-01

    Background: The human tissues continuously undergo modification as deposition of calcium (CA) salts either in an organized or disorganized pattern. The latter pattern usually occurs in the soft tissues such as in arteries, brain, kidneys, lungs, and dental pulp. The purpose of this study is to evaluate the presence of pulp calcification and carotid artery calcification (CDC) as a marker for renal calcification and altered serum biomarkers such as serum CA, phosphorus (P), and alkaline phospha...

  12. Aneurisma aterosclerótico da artéria axilar. Um caso clínico raro Atherosclerotic axillary artery aneurysm of a rare case

    Directory of Open Access Journals (Sweden)

    Luís F. Antunes

    2011-06-01

    Full Text Available Os aneurismas da artéria axilar de origem aterosclerótica são raros, mas podem originar complicações vasculares e neurológicas graves no membro superior, pelo que o seu tratamento deve ser precoce. Apresentamos o caso clínico de um homem de 64 anos com aneurisma da artéria axilar direita. O doente tinha antecedentes de aneurisma da aorta torácica já excluído por via endovascular. Devido ao crescimento súbito do aneurisma com sintomas neurológicos, foi submetido a aneurismectomia total com interposição de prótese PTFE 8 não aneladada (axilo-axilar. O estudo histológico revelou tratar-se de um aneurisma de origem aterosclerótica. Em consulta de follow-up o doente apresenta melhoria clínica e prótese permeável. O presente caso clínico realça a importância e os bons resultados que o tratamento cirúrgico tem nestes doentes.Atherosclerotic axillary artery aneurysms are very rare, but they can cause severe vascular or neurologic complications in the upper limb. Early treatment is mandatory. The authors report a case of a 64 years man with a right axillary artery aneurysm. The patient has had a previous exclusion of thoracic aortic aneurysm by endograft (TEVAR. Due to the sudden growth of aneurysm and neurologic symptoms, he was submitted to total aneurismectomy and interposition of axillary-axillary prosthetic graft (PTFE 8 without rings. The histological study shows an atherosclerotic aneurysm. In the follow-up the patient presented an improving clinical status of the upper limb and a patent graft. Present case report shows the importance and good outcome of surgical treatment in such patients.

  13. Transcatheter ablation of an iatrogenic renal artery pseudoaneurysm with absolute alcohol: A rare case report

    OpenAIRE

    Beig, Jahangir; Hafeez, Imran; Tramboo, Nisar Ahmed; Rather, Hilal; Yaqoob, Irfan

    2014-01-01

    A 25 year old male was admitted with features of life threatening renal haemorrhage after undergoing open nephrolithotomy for a staghorn calculus of the right kidney. CECT abdomen and selective renal angiography revealed a 2.5 × 3.0 cm pseudoaneurysm arising from the lower segmental branch of right renal artery, leaking into retroperitoneal space. After an initial failed attempt of transcatheter embolization with N-butyl cyanoacrylate (NBCA) and 10% lipiodol mixture, the pseudoaneurysm was su...

  14. The effect of lipid regulation with atorvastatin on the blood lipid levels and carotid artery plaques in patients with atherosclerotic cerebral infarction

    Directory of Open Access Journals (Sweden)

    Shu XU

    2015-11-01

    Full Text Available Objective To analyze the effect of intensive lipid regulation treatment with atorvastatin on the blood lipid levels and carotid artery plaques in patients with atherosclerotic cerebral infarction.  Methods Ninety-two patients with atherosclerotic cerebral infarction were randomly divided into two groups: observation group (treated by atorvastatin calcium with the dosage of 20 mg/d, N = 46 and control group (treated by diet without lipid-rich food, N=46. Besides, other drugs given to the patients in two groups were the same. The blood lipid levels and the changes of carotid artery plaques in two groups were analyzed and compared before treatment and 3 months after treatment. Results After treatment, the concentrations of total cholesterol [TC, (4.23 ± 0.92 mmol/L vs (5.24 ± 0.68 mmol/L], triglyceride [TG, (2.46 ± 0.28 mmol/L vs (3.33 ± 0.47 mmol/L], low-density lipoprotein cholesterol [LDL-C, (2.52 ± 0.38 mmol/L vs (4.78 ± 0.86 mmol/L] in the patients of observation group were all decreased and significantly lower than those in the control group (P = 0.000, for all, and the concentration of high-density lipoprotein cholesterol [HDL-C, (1.13 ± 0.41 mmol/L vs (0.85 ± 0.32 mmol/L] in the patients of observation group was increased and significantly than that in the control group (P = 0.003. The carotid artery plaque size [(20.25 ± 0.32 mm2 vs (24.42 ± 10.33 mm2] and thickness [(0.59 ± 0.13 mm vs (1.93 ± 0.23 mm] of carotid artery plaques and intima?media thickness [IMT, (1.32 ± 0.67 mm vs (1.63 ± 0.56 mm] of common carotid artery (CCA in the patients of observation group were all significantly lower than those in patients in the control group (P = 0.000, 0.000, 0.010, respectively. Comparing serum alanine aminotransferase (ALT, aspartate aminotransferase (AST, creatine kinase (CK and creatinine (Cr levels after treatment with before treatment, there was no significant difference between 2 groups (P > 0.05, for all.  Conclusions

  15. Effects of hypoproteinemia on renal hemodynamics, arterial pressure, and fluid volume

    International Nuclear Information System (INIS)

    The effects of long-term hypoproteinemia on renal hemodynamics, arterial pressure, and fluid volume were studied in eight conscious dogs over a 34-day period. Plasma protein concentration (PPC) was decreased by daily plasmapheresis, and the effects of decreasing and increasing sodium intake were measured. By the 12th day of plasmapheresis PPC had decreased to 2.5 g/dl from a control value of 7.2 g/dl, mean arterial pressure had decreased to 78% of control, glomerular filtration rate (GFR) was 75.2% of control, and urinary sodium excretion was decreased. By day 18 of plasmapheresis, estimated renal plasma flow (ERPF) was decreased to 60% of control due to the decreased arterial pressure and an increase in renal vascular resistance. GFR and ERPF were determined from the total clearance of [125I]iothalamate and [131I]iodohippurate. Also, plasma renin activity and plasma aldosterone concentration were both increased, and the relationship between mean arterial pressure and urinary sodium excretion was distinctly shifted to the left along the arterial pressure axis. In contradistinction to acute experiments, chronic hypoproteinemia results in decreases in GFR, ERPF, and urinary sodium excretion and has marked effects on both fluid volume and arterial pressure regulation

  16. Urinoma and arterial hypertension complicating neonatal renal candidiasis

    International Nuclear Information System (INIS)

    During antibiotic treatment for E.coli urinary tract infection and meningitis, a male new born developed a Candida albicans urinary tract infection with a mycotic kidney abcess and pelvicalyceal fungus balls diagnosed by US investigations and confirmed by radiology. Three weeks later a perirenal urinoma with arterial hypertension developed. After surgical treatment of the urinoma the arterial pressure returned to normal. (orig.)

  17. Urinoma and arterial hypertension complicating neonatal renal candidiasis

    Energy Technology Data Exchange (ETDEWEB)

    Sirinelli, D.; Schmit, P.; Biriotti, V.; Bensman, A.; Lupold, M.

    1987-02-01

    During antibiotic treatment for E.coli urinary tract infection and meningitis, a male new born developed a Candida albicans urinary tract infection with a mycotic kidney abcess and pelvicalyceal fungus balls diagnosed by US investigations and confirmed by radiology. Three weeks later a perirenal urinoma with arterial hypertension developed. After surgical treatment of the urinoma the arterial pressure returned to normal.

  18. Renal hemodynamics and oxygenation in transient renal artery occluded rats evaluated with iron-oxide particles and oxygenation-sensitive imaging

    Energy Technology Data Exchange (ETDEWEB)

    Pedersen, Michael [Aarhus Univ. Hospital (Denmark). MR Research Centre; Aarhus Univ. (Denmark). Inst. of Experimental Clinical Medicine; Univ. Victor Segalen Bordeaux 2 (France). Lab. Imagerie Moleculaire et Fonctionnelle: de la physiologie a la therapie CNRS UMR 5231; Laustsen, Christoffer [Aarhus Univ. Hospital (Denmark). MR Research Centre; Perot, Vincent; Grenier, Nicolas [Hopital Pellegrin, CHU Bordeaux (France). Service d' Imagerie Diagnostique et Therapeutique de l' Adulte; Basseau, Fabrice; Moonen, Chrit [Univ. Victor Segalen Bordeaux 2 (France). Lab. Imagerie Moleculaire et Fonctionnelle: de la physiologie a la therapie CNRS UMR 5231

    2010-07-01

    Mild or severe renal arterial occlusion is a phenomenon occasionally observed in daily clinical practice, potentially leading to renal ischemia and a general impairment of renal function. Secondly, closing the blood flow to the kidneys can also occur during kidney transplantation procedures. However, the exact physiological effects of these conditions on renal blood perfusion as well as the renal oxygen handling are poorly understood. The objectives of this study were therefore to measure the lateral changes of renal blood perfusion in rats subjected to transient unilateral arterial occlusion (RAS), and in addition, to measure the consequences on the intrarenal oxygenation. Experimental studies were performed using sixteen adolescent rats. The left renal artery was exposed through a flank incision and acute RAS for 45 min was achieved by placing a ligature around the renal artery. MRI was performed 3 days after the surgical procedure, where a blood oxygenation sensitive sequence (BOLD MRI) was performed, followed by a perfusion-weighted imaging sequence using a single bolus of the iron-oxide nanoparticle Sinerem. The renal oxygenation of blood was indirectly measured by the BOLD-parameter R2{sup *}, and perfusion measures include relative renal blood flow, relative renal blood volume and mean transit time. Histopathologic changes through the outer stripe of the outer medulla showing typical histopathologic findings of ischemia. This study demonstrated that rats with transient renal arterial stenosis (for 45 min) showed a reduction in intrarenal oxygenation and intrarenal blood flow three days after the surgical procedure. A decreased R2{sup *} was measured within the ipsilateral medulla in parallel with a decreased medullary blood flow, is probably related to a lower reabsorption load within the ipsilateral kidney. MRI may therefore be a promising tool in long-term evaluation of RAS. (orig.)

  19. Arterial Stiffness and Impaired Renal Function in Patients With and Without Diabetes Mellitus

    Directory of Open Access Journals (Sweden)

    Georgescu Olivia

    2014-06-01

    Full Text Available Background and aims: Cardio-Ankle Vascular Index (CAVI was developed as an index of arterial stiffness independently of blood pressure and other markers of early atherosclerosis. The aim of the study was to assess the correlations between CAVI and renal disease in type 2 diabetic patients compared with those without diabetes. Material

  20. Effects of olmesartan on arterial stiffness in rats with chronic renal failure

    Directory of Open Access Journals (Sweden)

    Chuang Yao-Chen

    2012-06-01

    Full Text Available Abstract Background It has been suggested that the antioxidant properties of olmesartan (OLM, an angiotensin II type 1 receptor (AT1R blocker, contribute to renal protection rather than blood pressure lowering effects despite the fact that causal relationships between hypertension and renal artery disease exist. This study aimed to examine the hypothesis whether the antioxidative activities of OLM were correlated to arterial stiffness, reactive oxygen species and advanced glycation end products (AGEs formation in rats with chronic renal failure (CRF. Methods CRF rats were induced by 5/6 nephrectomy and randomly assigned to an OLM (10 mg/day group or a control group. Hemodynamic states, oxidative stress, renal function and AGEs were measured after 8 weeks of OLM treatment. Results All the hemodynamic derangements associated with renal and cardiovascular dysfunctions were abrogated in CRF rats receiving OLM. Decreased cardiac output was normalized compared to control (p p p p p p p  Conclusion OLM treatment could ameliorate arterial stiffness in CRF rats with concomitant inhibition of MDA and AGEs levels through the reduction of oxidative stress in aortic wall.

  1. Reversible renal impairment induced by treatment with the angiotensin II receptor antagonist candesartan in a patient with bilateral renal artery stenosis

    Directory of Open Access Journals (Sweden)

    Kjaer Andreas

    2001-05-01

    Full Text Available Abstract Background It is well established that ACE-inhibitors should be avoided in patients with renal artery stenosis. In recent years it has also been recommended that caution should be demonstrated when angiotensin II blockers are used in the same type of patients but the evidence is based only on few cases. Results We describe a case where use of the angiotensin II antagonist candesartan (Atacand induced renal failure in a patient with bilateral renal artery stenosis. The course of the case is enlighted by results from sequential renography, selective renal vein catheterisation for measurement of renin, and angiographic findings. Conclusions In patients with renal artery stenosis the angiotensin II antagonist candesartan should be avoided.

  2. A new liquid embolic agent (embol) for transcatheter renal artery embolization: an experimental study in rabbit

    International Nuclear Information System (INIS)

    To evaluate the effectiveness and safety of a new liquid embolic agent in renal arterial embolization in the rabbit, and its clinical applicability. A new embolic agent, Embol, was obtained by partial hydrolysis of polyvinyl acetate and dissolved in a mixture of 45% ethanol and 55% non-ionic contrast medium. Its radio opacity was therefore good. An average of 0.8 cc(0.5-0.9cc) of Embol was used to embolize the renal artery of one kidney in 15 rabbits. The immediate effect of this was examined angiographically 5 minutes after the procedure. To permit histologic examination, five rabbits in each group were sacrificed 3 days (I), 2 weeks (II), and 4 weeks (III) after embolization: prior to embolization and prior to sacrifice, one rabbit in each group underwent renal scanning, and prior to sacrifice all underwent follow-up angiography. In three rabbits, blood urea nitrogen (BUN), creatinine, sodium (Na), and potassium (K) levels were measured before and 1,3,5,7 and 14 days after embolization. Embol was easy to use and its radiopacity was good. Five minutes after embolization, angiography showed that total occlusion of the main renal or interlobar artery had been achieved in all rabbits. Serum BUN, creatinine, Na and K levels were within normal limits. Follow-up angiogram obtained in each group showed persistent occlusion of the renal artery in all but one rabbit in group I and one in group III. Renal scans revealed no evidence of radionuclide uptake in embolized kidneys, which were slightly enlarged in group I but became gradually smaller in groups II and III. In all animals, histologic examination showed diffuse coagulation necrosis of the embolized kidneys and in group III the cortex of these was extensively calcified. In group I the renal artery showed an apparently fresh occluding thrombosis, and in groups II and III a completely organized thrombosis was present. In group III this was calcified. Because of its good radio opacity, Embol is easy to contrast, and is

  3. Spectrum of results of arterial digital subtraction angiography in patients after renal transplantation

    International Nuclear Information System (INIS)

    Digital subtraction angiography (DSA) was performed in 53 of 417 patients with renal transplants. The incidence of clinical apparent vascular complications was 9.1% of all patients with renal transplants (38/417). The most frequent vascular disorders were formed by arterial stenoses at 5.0% of the cases followed by arterial obstructions in 1.7% of the patients. Rare vascular complications were arteriovenous fistulas (0.7%), aneurysms (0.5%) and venous thrombose (0.2%). Because of the high diagnostic value of intraarterial DSA, all patients with renal transplants with a complicated postoperative course should be eligible for angiographic control. In case of a suspected vascular disorder intraarterial DSA should be performed at an early stage. (orig.)

  4. Left sided circumaortic and retroaortic left renal veins, renal artery arising from iliac common artery in L-shaped kidney

    International Nuclear Information System (INIS)

    Full text: Introduction: Renal ectopia is a congenital anomaly with variable clinical presentation. Kidneys are normally located in the retroperitoneal position, on either side of vertebral column, against the psoas muscles but when not at such position, it is called renal ectopia or ectopic kidney. Ectopic kidneys are thought to occur in approximately 1 in 1,000 births but only about 1 in 10 of these is ever diagnosed. In 90% of crossed ectopy, there is at least partial fusion of the kidneys. Left-to right ectopy is thought to be three times more common. Some of these are discovered incidentally, when a child or adult is having ultrasonography for a medical condition unrelated to renal ectopia. In a crossed fused renal ectopic kidney, complications such as nephrolithiasis, infection, and hydronephrosis approaches over 50%. Simple renal ectopia refers to kidney that is located on the proper side but abnormal in position. Crossed renal ectopia was first described by Pannorlus in 1964 and refer to kidney that has crossed from left to right or vice-versa, with moving of one kidney to the opposite side following ascent of the other kidney, so that both kidneys are located on the same side of the body, mostly fused called crossed fused ectopia. The fusion of the two kidneys is believed to result from (1) failure of the primitive nephrogenic cell masses to separate or (2) fusion of the two blastemas during their abdominal ascent. Discussion: A 57-year-old woman with a new found hematological disease. CT exam was performed with intravenous application of contrast media. Like an additional findings we visualized the presence of right to-left ectopy (L - shaped kidney) and the presence of left circumaortic renal vein emanating from a normally situated left kidney and retroaortic renal vein as having been located by the ectopic right kidney. Conclusion: By crossed renal ectopia is meant congenital displacement of one kidney to the opposite side. The conditional may present

  5. Comparison of radiofrequency-ablation lesion size with occlusion of renal vessels in rabbit kidneys: occlusion of renal artery, vein, and both vessels

    Energy Technology Data Exchange (ETDEWEB)

    Choi, Hyuck Jae; Kim, In One [National Cancer Center, Seoul (Korea, Republic of); Lee, Jeong Min [Seoul National University College of Medicine, Seoul (Korea, Republic of)] (and others)

    2007-09-15

    The purpose of this study was to compare the in-vivo efficiency of vascular occlusion on radiofrequency ablation (RFA) lesion size in a rabbit kidney model. RFA lesions were created in a single kidney in 20 rabbits using an internally cooled electrode. Twenty ablation zones (1 per kidney) were created using 4 different regimens: RFA without vascular occlusion (n = 5), RFA with renal artery occlusion (n = 5), RFA with renal vein occlusion (n 5), RFA with renal artery and vein occlusion (n = 5). Seven days later, the rabbits were sacrificed and the lesions were excised. These groups were then compared with respect to the dimensions of the ablation zones and the changes in impedance and current during RFA. The maximum ablation zone width was the greatest in the renal artery and vein occlusion group (21.0 {+-} 1.4 mm), followed by the renal artery occlusion group (17.8 {+-} 1.0 mm), the renal vein occlusion group (17.4 {+-} 1.1 mm), and the nonocclusion group (7.8 {+-} 2.4 mm) ({rho} < 0.05). No significant differences were observed for impedances and currents between the 4 groups. Vascular occlusion combined with RFA effectively increased ablation zone dimensions compared with RFA alone, and the best effect was accomplished by combined renal artery and vein occlusion.

  6. Renal sympathetic nervous system and the effects of denervation on renal arteries

    Institute of Scientific and Technical Information of China (English)

    Arun; Kannan; Raul; Ivan; Medina; Nagapradeep; Nagajothi; Saravanan; Balamuthusamy

    2014-01-01

    Resistant hypertension is associated with chronic activation of the sympathetic nervous system resulting in various comorbidities. The prevalence of resistant hypertension is often under estimated due to various reasons. Activation of sympathetic nervous system at the renal-as well as systemic-level contributes to the increased level of catecholamines and resulting increase in the blood pressure. This increased activity was demonstrated by increased muscle sympathetic nerve activity and renal and total body noradrenaline spillover. Apart from the hypertension, it is hypothesized to be associated with insulin resistance, congestive heart failure and obstructive sleep apnea. Renal denervation is a novel procedure where the sympathetic afferent and efferent activity is reduced by various techniques and has been used successfully to treat drug-resistant hypertension improvement of various metabolic derangements.Renal denervation has the unique advantage of offering the denervation at the renal level, thus mitigating the systemic side effects. Renal denervation can be done by various techniques including radiofrequency ablation, ultrasound guided ablation and chemical ablation. Various trials evaluated the role of renal denervation in the management of resistant hypertension and have found promising results. More studies are underway to evaluate the role of renal denervation in patients presenting with resistant hypertension in different scenarios. Appropriate patient selection might be the key in determining the effectiveness of the procedure.

  7. Renal artery stenosis in kidney transplants: assessment of the risk factors

    Directory of Open Access Journals (Sweden)

    Etemadi J

    2011-08-01

    Full Text Available Jalal Etemadi1, Khosro Rahbar2, Ali Nobakht Haghighi2, Nazila Bagheri2, Kianoosh Falaknazi2, Mohammad Reza Ardalan1, Kamyar Ghabili3, Mohammadali M Shoja31Department of Nephrology, Dialysis and Transplantation, Tabriz University of Medical Sciences, Tabriz, 2Department of Nephrology, Shaheed Beheshti University of Medical Sciences, Tehran, 3Tuberculosis and Lung Disease Research Center, Tabriz University of Medical Sciences, Tabriz, IranBackground: Transplant renal artery stenosis (TRAS is an important cause of hypertension and renal allograft dysfunction occurring in kidney transplant recipients. However, conflicting predisposing risk factors for TRAS have been reported in the literature.Objective: The aim of the present study was to assess the potential correlation between possible risk factors and TRAS in a group of living donor renal transplant recipients 1 year after the renal transplantation.Methods: We evaluated the presence of renal artery stenosis in 16 recipients who presented with refractory hypertension and/or allograft dysfunction 1 year after renal transplantation. Screening for TRAS was made by magnetic resonance angiography and diagnosis was confirmed by conventional renal angiography. Age, gender, history of acute rejection, plasma lipid profile, serum creatinine, blood urea nitrogen, serum uric acid, calcium phosphate (CaPO4 product, alkaline phosphatase, fasting blood sugar, hemoglobin, and albumin were compared between the TRAS and non-TRAS groups.Results: Of 16 kidney transplant recipients, TRAS was diagnosed in three patients (two men and one woman. High levels of calcium, phosphorous, CaPO4 product, and low-density lipoprotein (LDL cholesterol were significantly correlated with the risk of TRAS 1 year after renal transplantation (P < 0.05. Serum level of uric acid tended to have a significant correlation (P = 0.051.Conclusion: Correlation between high CaPO4 product, LDL cholesterol, and perhaps uric acid and TRAS in living

  8. Arterial baroreceptor reflex control of renal sympathetic nerve activity following chronic myocardial infarction in male, female, and ovariectomized female rats.

    Science.gov (United States)

    Pinkham, Maximilian I; Whalley, Gillian A; Guild, Sarah-Jane; Malpas, Simon C; Barrett, Carolyn J

    2015-07-15

    There is controversy regarding whether the arterial baroreflex control of renal sympathetic nerve activity (SNA) in heart failure is altered. We investigated the impact of sex and ovarian hormones on changes in the arterial baroreflex control of renal SNA following a chronic myocardial infarction (MI). Renal SNA and arterial pressure were recorded in chloralose-urethane anesthetized male, female, and ovariectomized female (OVX) Wistar rats 6-7 wk postsham or MI surgery. Animals were grouped according to MI size (sham, small and large MI). Ovary-intact females had a lower mortality rate post-MI (24%) compared with both males (38%) and OVX (50%) (P < 0.05). Males and OVX with large MI, but not small MI, displayed an impaired ability of the arterial baroreflex to inhibit renal SNA. As a result, the male large MI group (49 ± 6 vs. 84 ± 5% in male sham group) and OVX large MI group (37 ± 3 vs. 75 ± 5% in OVX sham group) displayed significantly reduced arterial baroreflex range of control of normalized renal SNA (P < 0.05). In ovary-intact females, arterial baroreflex control of normalized renal SNA was unchanged regardless of MI size. In males and OVX there was a significant, positive correlation between left ventricle (LV) ejection fraction and arterial baroreflex range of control of normalized renal SNA, but not absolute renal SNA, that was not evident in ovary-intact females. The current findings demonstrate that the arterial baroreflex control of renal SNA post-MI is preserved in ovary-intact females, and the state of left ventricular dysfunction significantly impacts on the changes in the arterial baroreflex post-MI. PMID:25994953

  9. Evaluation of texture parameters for the quantitative description of multimodal nonlinear optical images from atherosclerotic rabbit arteries

    International Nuclear Information System (INIS)

    The composition and structure of atherosclerotic lesions can be directly related to the risk they pose to the patient. Multimodal nonlinear optical (NLO) microscopy provides a powerful means to visualize the major extracellular components of the plaque that critically determine its structure. Textural features extracted from NLO images were investigated for their utility in providing quantitative descriptors of structural and compositional changes associated with plaque development. Ten texture parameters derived from the image histogram and gray level co-occurrence matrix were examined that highlight specific structural and compositional motifs that distinguish early and late stage plaques. Tonal-texture parameters could be linked to key histological features that characterize vulnerable plaque: the thickness and density of the fibrous cap, size of the atheroma, and the level of inflammation indicated through lipid deposition. Tonal and texture parameters from NLO images provide objective metrics that correspond to structural and biochemical changes that occur within the vessel wall in early and late stage atherosclerosis.

  10. Evaluation of texture parameters for the quantitative description of multimodal nonlinear optical images from atherosclerotic rabbit arteries

    Energy Technology Data Exchange (ETDEWEB)

    Mostaco-Guidolin, Leila B; Ko, Alex C-T; Popescu, Dan P; Smith, Michael S D; Kohlenberg, Elicia K; Sowa, Michael G [Institute for Biodiagnostics, National Research Council Canada, Winnipeg, R3B 1Y6 (Canada); Shiomi, Masashi [Institute of Experimental Animals, School of Medicine, Kobe University, Kobe 650-0017 (Japan); Major, Arkady [Department Electrical and Computer Engineering, University of Manitoba, E3-559 Engineering Building, Winnipeg, R3T 5V6 (Canada)

    2011-08-21

    The composition and structure of atherosclerotic lesions can be directly related to the risk they pose to the patient. Multimodal nonlinear optical (NLO) microscopy provides a powerful means to visualize the major extracellular components of the plaque that critically determine its structure. Textural features extracted from NLO images were investigated for their utility in providing quantitative descriptors of structural and compositional changes associated with plaque development. Ten texture parameters derived from the image histogram and gray level co-occurrence matrix were examined that highlight specific structural and compositional motifs that distinguish early and late stage plaques. Tonal-texture parameters could be linked to key histological features that characterize vulnerable plaque: the thickness and density of the fibrous cap, size of the atheroma, and the level of inflammation indicated through lipid deposition. Tonal and texture parameters from NLO images provide objective metrics that correspond to structural and biochemical changes that occur within the vessel wall in early and late stage atherosclerosis.

  11. Evaluation of arterial impairment after experimental gelatin sponge embolization in a rabbit renal model

    Energy Technology Data Exchange (ETDEWEB)

    Oh, Jung Suk; Lee, Hae Gi; Chun, Ho Jong; Choi, Byung Gil; Choi, Yeong Jin [Seoul St. Mary' s Hospital, College of Medicine, The Catholic University of Korea, Seoul (Korea, Republic of)

    2015-02-15

    Arterial stenosis is a major obstacle for subsequent interventional procedures. We hypothesized that the stenosis is caused by gelatin sponge embolization and performed an experimental study in a rabbit renal model. A total of 24 rabbits were embolized with porcine gelatin sponge particles injected into the renal arteries. Four rabbits were sacrificed on 1 day, 4 days, 1 week, 2 weeks, 3 weeks, and 4 weeks after embolization. Microscopic evaluations were performed on hematoxylin-eosin and smooth muscle actin immunohistochemical stained sections. Gelatin sponge particles were mainly observed in the segmental and interlobar arteries. Transmural inflammation of the embolized arterial wall and mild thickening of the media were observed 1 week after embolization. Resorption of the gelatin sponge and organization of thrombus accompanied by foreign body reactions, were observed from 2 to 4 weeks after embolization. Microscopic images of the 3 weeks group showed vessel lumens filled mostly with organized thrombi, resulting in severe stenosis. Additionally, vessels showed a thickened intima that contained migrating smooth muscle cells and accompanying interruption of the internal elastic lamina. The migrating smooth muscle cells were distributed around the recanalized arterial lumen. Gelatin sponge embolization may induce arterial stenosis by causing organized thrombus and intimal hyperplasia, which consists of migrating smooth muscle cells and intimal collagen deposits.

  12. Evaluation of arterial impairment after experimental gelatin sponge embolization in a rabbit renal model

    International Nuclear Information System (INIS)

    Arterial stenosis is a major obstacle for subsequent interventional procedures. We hypothesized that the stenosis is caused by gelatin sponge embolization and performed an experimental study in a rabbit renal model. A total of 24 rabbits were embolized with porcine gelatin sponge particles injected into the renal arteries. Four rabbits were sacrificed on 1 day, 4 days, 1 week, 2 weeks, 3 weeks, and 4 weeks after embolization. Microscopic evaluations were performed on hematoxylin-eosin and smooth muscle actin immunohistochemical stained sections. Gelatin sponge particles were mainly observed in the segmental and interlobar arteries. Transmural inflammation of the embolized arterial wall and mild thickening of the media were observed 1 week after embolization. Resorption of the gelatin sponge and organization of thrombus accompanied by foreign body reactions, were observed from 2 to 4 weeks after embolization. Microscopic images of the 3 weeks group showed vessel lumens filled mostly with organized thrombi, resulting in severe stenosis. Additionally, vessels showed a thickened intima that contained migrating smooth muscle cells and accompanying interruption of the internal elastic lamina. The migrating smooth muscle cells were distributed around the recanalized arterial lumen. Gelatin sponge embolization may induce arterial stenosis by causing organized thrombus and intimal hyperplasia, which consists of migrating smooth muscle cells and intimal collagen deposits.

  13. Improved evaluation of renal transplant perfusion by deconvolution of the artery bolus

    International Nuclear Information System (INIS)

    Full text: Perfusion indices can assist in renal transplant management. Chaiwatanarat et al. (J Nucl Med 1994; 35: 1792) deconvolved the artery bolus from the renal bolus to generate an index which discriminated between acute tubular necrosis (ATN) and acute rejection. We could not replicate this result, however, so we have investigated refinements to the method. Our criterion for success was separation between 13 ATN and 8 acute rejection patients, either on the basis of a single scan or when compared to a day 1 baseline scan. We acquired 40 one-second perfusion images and applied iliac artery, kidney and background ROls to generate background-corrected iliac artery and kidney curves. We applied the following methods of preprocessing the curves to optimize Fourier deconvolution: (1) the conventional method of appending a curve (cosine or exponential) to the end of the data at various points after the bolus peak; (2) a new approach of subtracting an estimate of the functional component from the renal curve before deconvolution. Neither method was successful with a single scan. When compared to a baseline scan, method 1 (as used in the above publication) still did not separate ATN and rejection, and varying the appended curves and their starting points did not help. When compared to a baseline scan, however, method 2 was successful providing the perfusion index was computed using the response function up to the end of the first pass of the artery bolus. The form of the function curve subtracted was found to be critical

  14. Correlation of dental pulp stones, carotid artery and renal calcifications using digital panoramic radiography and ultrasonography

    Directory of Open Access Journals (Sweden)

    Garima Yeluri

    2015-01-01

    Full Text Available Background: The human tissues continuously undergo modification as deposition of calcium (CA salts either in an organized or disorganized pattern. The latter pattern usually occurs in the soft tissues such as in arteries, brain, kidneys, lungs, and dental pulp. The purpose of this study is to evaluate the presence of pulp calcification and carotid artery calcification (CDC as a marker for renal calcification and altered serum biomarkers such as serum CA, phosphorus (P, and alkaline phosphatase (ALP. Materials and Methods: Digital panoramic radiographs of 50 patients with the presence of pulp stones and suspected CAC were subjected to carotid artery and renal ultrasonography (USG examination for the presence of vascular calcification and also to evaluate the alterations in serum CA, P, and ALP levels. Data were analyzed statistically using Chi-square test. Results: Panoramic radiographs of 50 patients showed 88.28% of teeth with the presence of pulp stones stones and 91% carotid arteries with calcification. The sensitivity of panoramic radiograph was greater than that of USG (93.67%, but the specificity of USG was more than the panoramic radiograph (44.44% in detecting CAC. The prevalence rate of renal calcification on USG was 92%. The statistical difference between the patients with or without alteration in serum Ca levels was not significant (χ2 = 0.581 and P = 0.446. On comparison of serum P and ALP, the difference was found to be statistically significant. Conclusion: Presence of pulp stones and CAC's on panoramic radiograph have remarkably proved to establish the chances of renal artery calcification associated with alterations in serum CA levels.

  15. Renal cell carcinoma metastases to the pancreas - Value of arterial phase imaging at MDCT

    Energy Technology Data Exchange (ETDEWEB)

    Corwin, Michael T. [Univ. of California, Davis Medical Center, Dept. of Radiology, Sacramento (United States)], e-mail: Michael.corwin@ucdmc.ucdavis.edu; Lamba, Ramit; McGahan, John P. [Univ. of California, Davis Medical Center, Dept. of Radiology, Sacramento (United States); Wilson, Machelle [Univ. of California, Davis, Dept. of Public Health Sciences (United States)

    2013-04-15

    Background: The pancreas is an increasingly recognized site of renal cell carcinoma metastases. It is important to determine the optimal MDCT protocol to best detect RCC metastases to the pancreas. Purpose: To compare the rate of detection of renal cell carcinoma metastases to the pancreas between arterial and portal venous phase MDCT. Material and Methods: A retrospective review of CTs of the abdomen yielded six patients with metastatic RCC to the pancreas. Five of six patients had pathologically proven clear cell RCC. Two blinded reviewers independently reported the number of pancreatic lesions seen in arterial and venous phases. Each lesion was graded as definite or possible. The number of lesions was determined by consensus review of both phases. Attenuation values were obtained for metastatic lesions and adjacent normal pancreas in both phases. Results: There were a total of 24 metastatic lesions to the pancreas. Reviewer 1 identified 20/24 (83.3%) lesions on the arterial phase images and 13/24 (54.2%) lesions on the venous phase. Seventeen of 20 (85.0%) arterial lesions were deemed definite and 9/13 (69.2%) venous lesions were definite. Reviewer 2 identified 19/24 (79.2%) lesions on the arterial phase and 14/24 (58.3%) on the venous phase. Seventeen of 19 (89.5%) arterial lesions were definite and 7/14 (50%) venous lesions were definite. Mean attenuation differential between lesion and pancreas was 114 HU and 39 HU for arterial and venous phases, respectively (P<0.0001). Conclusion: Detection of RCC metastases to the pancreas at MDCT is improved using arterial phase imaging compared to portal venous phase imaging.

  16. Renal cell carcinoma metastases to the pancreas - Value of arterial phase imaging at MDCT

    International Nuclear Information System (INIS)

    Background: The pancreas is an increasingly recognized site of renal cell carcinoma metastases. It is important to determine the optimal MDCT protocol to best detect RCC metastases to the pancreas. Purpose: To compare the rate of detection of renal cell carcinoma metastases to the pancreas between arterial and portal venous phase MDCT. Material and Methods: A retrospective review of CTs of the abdomen yielded six patients with metastatic RCC to the pancreas. Five of six patients had pathologically proven clear cell RCC. Two blinded reviewers independently reported the number of pancreatic lesions seen in arterial and venous phases. Each lesion was graded as definite or possible. The number of lesions was determined by consensus review of both phases. Attenuation values were obtained for metastatic lesions and adjacent normal pancreas in both phases. Results: There were a total of 24 metastatic lesions to the pancreas. Reviewer 1 identified 20/24 (83.3%) lesions on the arterial phase images and 13/24 (54.2%) lesions on the venous phase. Seventeen of 20 (85.0%) arterial lesions were deemed definite and 9/13 (69.2%) venous lesions were definite. Reviewer 2 identified 19/24 (79.2%) lesions on the arterial phase and 14/24 (58.3%) on the venous phase. Seventeen of 19 (89.5%) arterial lesions were definite and 7/14 (50%) venous lesions were definite. Mean attenuation differential between lesion and pancreas was 114 HU and 39 HU for arterial and venous phases, respectively (P<0.0001). Conclusion: Detection of RCC metastases to the pancreas at MDCT is improved using arterial phase imaging compared to portal venous phase imaging

  17. Reversible diminished renal sup(99m)Tc-DMSA uptake during converting-enzyme inhibition in a patient with renal artery stenosis

    Energy Technology Data Exchange (ETDEWEB)

    Kremer Hovinga, T.K.; Beukhof, J.R.; Donker, A.J.M.; Luyk, W.H.J. van; Piers, D.A.

    1984-03-01

    A patient is described who had accelerated hypertension and unilateral renal artery stenosis, and who developed further deterioration in renal function during treatment with captopril, an angiotension-I (AI) converting-enzyme inhibitor. sup(99m)Tc-DMSA uptake was greatly diminished in the stenotic kidney, although renal blood flow and handling of /sup 131/I hippurate was preserved. Uptake of sup(99m)Tc-DMSA in the affected kidney returned after substitution of captopril by the vasodilator minoxidil, while a comparable degree of blood pressure control was maintained. This, caution must be taken when interpreting results of sup(99m)Tc-DMSA scintigraphy in patients with proven or suspected renal artery stenosis treated with an AI converting-enzyme inhibiting drug. Moreover, our finding points to the importance of glomerular filtration in the renal handling of /sup 99/Tc-DMSA.

  18. Tratamento endovascular de angiomiolipoma renal por embolização arterial seletiva Endovascular treatment of renal angiomiolipoma by selective arterial embolization

    Directory of Open Access Journals (Sweden)

    Renato Menezes Palácios

    2012-12-01

    Full Text Available Relata-se um caso de um paciente com queixa principal de dor lombar à esquerda, portador de angiomiolipomas renais (AMLRs bilaterais, com a lesão mais volumosa de 6,2 cm em seu maior diâmetro, submetido a tratamento endovascular por embolização arterial superseletiva com microesferas. Os AMLRs são tumores benignos raros. A maioria é esporádica, enquanto uma minoria está associada à Esclerose Tuberosa Complexa (ETC. Os AMLRs maiores do que 4 cm devem ser tratados devido ao maior risco de complicações, principalmente hemorrágicas. A embolização arterial seletiva (EAS é um tratamento efetivo e seguro para os AMLRs.We report a case of a patient with a major complaint of left lumbar pain, diagnosed with bilateral renal angiomyolipomas (AMLRs, with the most voluminous lesion of 6.2 cm in its largest diameter, underwent endovascular superselective arterial embolization with microspheres. The AMLRs are rare benign tumors. Most are sporadic, while a minority is associated with Tuberous Sclerosis Complex (ETC. The AMLRs larger than 4 cm must be treated due to higher risk of complications, especially hemorrhagic. A selective arterial embolization (EAS is an effective and safe treatment for AMLRs.

  19. T-Stenting-and-Small-Protrusion Technique for Bifurcation Stenoses After End-to-Side Anastomosis of Transplant Renal Artery and External Iliac Artery: Report of Two Cases

    Energy Technology Data Exchange (ETDEWEB)

    Chen, Yong, E-mail: cheny102@163.com; Ye, Peng, E-mail: thomas19871223@163.com [Southern Medical University, Department of Interventional Radiology, Nanfang Hospital (China); Jiang, Wen-jin, E-mail: 18653501187@163.com [Yantai Yuhuangding Hospital (China); Ma, Shuo-yi, E-mail: mazelong123456789@126.com; Zhao, Jian-bo, E-mail: zhaojianbohgl@163.com; Zeng, Qing-le, E-mail: doctorzengqingle@126.com [Southern Medical University, Department of Interventional Radiology, Nanfang Hospital (China)

    2015-10-15

    Bifurcation stenoses after end-to-side anastomosis of transplant renal artery (TRA) and external iliac artery (EIA), including stenoses at the anastomosis and the iliac artery proximal to the TRA, are rare. In the present article, we report two successfully managed cases of bifurcation stenoses after end-to-side anastomosis of the TRA and EIA using the technique of T-stenting and small protrusion (TAP stenting)

  20. T-Stenting-and-Small-Protrusion Technique for Bifurcation Stenoses After End-to-Side Anastomosis of Transplant Renal Artery and External Iliac Artery: Report of Two Cases

    International Nuclear Information System (INIS)

    Bifurcation stenoses after end-to-side anastomosis of transplant renal artery (TRA) and external iliac artery (EIA), including stenoses at the anastomosis and the iliac artery proximal to the TRA, are rare. In the present article, we report two successfully managed cases of bifurcation stenoses after end-to-side anastomosis of the TRA and EIA using the technique of T-stenting and small protrusion (TAP stenting)

  1. Acute upregulation of COX-2 by renal artery stenosis

    DEFF Research Database (Denmark)

    Mann, Birgitte; Hartner, A; Jensen, B L;

    2001-01-01

    activity, and renin mRNA levels were determined. COX-2 mRNA and COX-2 immunoreactivity in the macula densa region in the clipped kidneys increased as early as 6 h after clipping and reached a maximal expression 1-2 days after clipping. Although values for plasma renin activity were elevated markedly at all...... causal relationship between the changes of COX-2 and of renin expression, clipped rats were treated with the COX-2 blocker celecoxib (40 mg. kg(-1). day(-1)). This treatment, however, did not change renin mRNA either in the clipped or in the contralateral intact kidney. Our findings indicate that renal...

  2. Arterial stiffness and endothelial dysfunction independently and synergistically predict cardiovascular and renal outcome in patients with type 1 diabetes

    DEFF Research Database (Denmark)

    Theilade, S; Lajer, Maria Stenkil; Jorsal, Anders;

    2012-01-01

    To evaluate whether pulse pressure alone or with placental growth factor as estimates of arterial stiffness and endothelial dysfunction, predicts mortality, cardiovascular disease and progression to end-stage renal disease in patients with Type 1 diabetes.......To evaluate whether pulse pressure alone or with placental growth factor as estimates of arterial stiffness and endothelial dysfunction, predicts mortality, cardiovascular disease and progression to end-stage renal disease in patients with Type 1 diabetes....

  3. 肾动脉及副肾动脉狭窄超声诊断及漏误诊分析%Analysis of Ultrasonic Diagnosis and Missed Diagnosis of Renal Artery and Accessory Renal Artery Stenosis

    Institute of Scientific and Technical Information of China (English)

    高小瞻; 胡文法; 马飞; 毛剑平; 梁社富

    2013-01-01

    Objective To evaluate the role of color doppler ultrasound in diagnosis of renal artery and accessory renal artery stenosis. Methods The sonographic appearance of color doppler ultrasound in 33 patients with renal artery and accessory renal artery stenosis were retrospectively analyzed, and were compared with imagings of CT angiography (CTA). The misdiagnosed causes of renal artery and accessory renal artery stenosis by ultrasonography were emphatically discussed. Results The 23 patients having accurately diagnosed as having accessory renal artery stenosis by CTA, 8 patients with renal artery and accessory renal artery stenosis and 2 patients having renal artery. The 23 patients were accurately diagnosed as having accessory renal artery stenosis by color doppler ultrasound, 8 patients were diagnosed as having renal artery and accessory renal artery stenosis by CTA results, accessory renal artery stenosis missed diagnosis, and 2 patients were misdiagnosed as having accessory renal artery stenosis who were first diagnosed as having renal artery stenosis by CTA results. 18 patients were diagnosed as having accessory renal artery stenosis, and 6 patients missed diagnosis by peak systolic velocity (PSV) of stenosis station as having index; 15 patients were diagnosed as having renal artery and accessory renal artery stenosis, 2 missed diagnosis, and 2 missed diagnosed by blood flow acceleration and accelerating time of segmental renal artery or interlobar arteries combined with blood flow velocity of renal artery and accessory renal artery as diagnosis indexes. The 10 patients who missed diagnosis were all confirmed with diagnosis by CAT. Conclusion Ultrasound is an important method in diagnosis, screening and differential diagnosis of accessory renal artery stenosis, although its sensitivity is lower than that by CTA.%目的 探讨彩色多普勒超声(彩超)检查在肾动脉及副肾动脉狭窄诊断中的应用价值.方法 对我院收治的

  4. Development of coronary artery stenosis in a patient with metastatic renal cell carcinoma treated with sorafenib

    International Nuclear Information System (INIS)

    Tyrosine kinase inhibitors (TKIs) are currently approved for the treatment of metastatic renal cell carcinoma (mRCC). The cardiotoxic effects of sorafenib and sunitinib may cause hypertension, left ventricular ejection fraction (LVEF) dysfunction and/or congestive heart failure (CHF), and arterial thrombo-embolic events (ATE). Only three cases of coronary artery disease related to sorafenib therapy have been described in the literature, and all were due to arterial vasospasm without evidence of coronary artery stenosis on angiography. Cardiotoxicity is commonly associated with the presence of cardiovascular risk factors, such as a history of hypertension or coronary artery disease. We describe a patient who experienced an unusual cardiac event after 2 years of sorafenib treatment. A 58-year-old man with mRCC developed acute coronary syndrome (ischemia/infarction) associated with critical sub-occlusion of the common trunk of the left coronary artery and some of its branches, which was documented on coronary angiography. The patient underwent triple coronary artery bypass surgery, and sorafenib treatment was discontinued. He did not have any cardiovascular risk factors, and his cardiac function and morphology were normal prior to sorafenib treatment. Further investigation of a larger patient population is needed to better understand cardiac damage due to TKI treatment. Understanding the usefulness of careful cardiovascular monitoring might be important for the prevention of fatal cardiovascular events, and to avoid discontinuation of therapy for the underlying cancer

  5. Development of coronary artery stenosis in a patient with metastatic renal cell carcinoma treated with sorafenib

    Directory of Open Access Journals (Sweden)

    Pantaleo Maria

    2012-06-01

    Full Text Available Abstract Background Tyrosine kinase inhibitors (TKIs are currently approved for the treatment of metastatic renal cell carcinoma (mRCC. The cardiotoxic effects of sorafenib and sunitinib may cause hypertension, left ventricular ejection fraction (LVEF dysfunction and/or congestive heart failure (CHF, and arterial thrombo-embolic events (ATE. Only three cases of coronary artery disease related to sorafenib therapy have been described in the literature, and all were due to arterial vasospasm without evidence of coronary artery stenosis on angiography. Cardiotoxicity is commonly associated with the presence of cardiovascular risk factors, such as a history of hypertension or coronary artery disease. Case presentation We describe a patient who experienced an unusual cardiac event after 2 years of sorafenib treatment. A 58-year-old man with mRCC developed acute coronary syndrome (ischemia/infarction associated with critical sub-occlusion of the common trunk of the left coronary artery and some of its branches, which was documented on coronary angiography. The patient underwent triple coronary artery bypass surgery, and sorafenib treatment was discontinued. He did not have any cardiovascular risk factors, and his cardiac function and morphology were normal prior to sorafenib treatment. Conclusions Further investigation of a larger patient population is needed to better understand cardiac damage due to TKI treatment. Understanding the usefulness of careful cardiovascular monitoring might be important for the prevention of fatal cardiovascular events, and to avoid discontinuation of therapy for the underlying cancer.

  6. Short-term effects of renal transplantation on coronary artery calcification: A prospective study

    Directory of Open Access Journals (Sweden)

    Pratyusha Priyadarshini

    2015-01-01

    Full Text Available Cardiovascular disease is a leading cause of mortality in renal transplant recipients. Coronary artery calcification (CAC has been found to have good correlation with atherosclerosis and cardiovascular morbidity. The objective of our study was to assess the prevalence of CAC and the long-term effects of renal transplantation on CAC and carotid intima-medial thickness (CIMT in Indian renal transplant recipients. Twenty-eight renal transplant recipients were included in this prospective study. Dual-source computed tomography and calcium scoring using Agatston′s method and CIMT measurement were performed at the time of transplant and then repeated at six and 12 months after transplantation. The prevalence of CAC in our study patients was low (32%, probably because they were young, had been on dialysis for a short duration and had undergone live-related renal transplant. An overall improvement in biochemical parameters was observed after transplantation. Patients with zero baseline calcium score did not show progression. Patients with baseline calcium score more than zero showed initial progression at 6 months and no further progression afterwards. There was good correlation between CIMT and CAC score. Our study suggests that renal transplantation does not reverse the calcification but appears to decrease the rate of progression in the long term.

  7. Analysis of the Sensitivity and Specificity of Noninvasive Imaging Tests for the Diagnosis of Renal Artery Stenosis

    International Nuclear Information System (INIS)

    Aging and atherosclerosis are related to renovascular hypertension in elderly individuals. Regardless of comorbidities, renal artery stenosis is itself an important cause of cardiovascular morbidity and mortality. To define the sensitivity, specificity, positive predictive value, and negative predictive value of noninvasive imaging tests used in the diagnosis of renal artery stenosis. In a group of 61 patients recruited, 122 arteries were analized, thus permitting the definition of sensitivity, specificity, and the relative contribution of each imaging study performed (Doppler, scintigraphy and computed tomographic angiography in comparison to renal arteriography). The mean age was 65.43 years (standard deviation: 8.7). Of the variables related to the study population that were compared to arteriography, two correlated with renal artery stenosis, renal dysfunction and triglycerides. The median glomerular filtration rate was 52.8 mL/min/m2. Doppler showed sensitivity of 82.90%, specificity of 70%, a positive predictive value of 85% and negative predictive value of 66.70%. For tomography, sensitivity was 66.70%, specificity 80%, positive predictive value 87.50% and negative predictive value 55.20%. With these findings, we could identify the imaging tests that best detected stenosis. Tomography and Doppler showed good quality and efficacy in the diagnosis of renal artery stenosis, with Doppler having the advantage of not requiring the use of contrast medium for the assessment of a disease that is common in diabetics and is associated with renal dysfunction and severe left ventricular dysfunction

  8. Analysis of the Sensitivity and Specificity of Noninvasive Imaging Tests for the Diagnosis of Renal Artery Stenosis

    Energy Technology Data Exchange (ETDEWEB)

    Borelli, Flavio Antonio de Oliveira, E-mail: fborelli@cardiol.br; Pinto, Ibraim M. F.; Amodeo, Celso; Smanio, Paola E. P.; Kambara, Antonio M.; Petisco, Ana Claudia G.; Moreira, Samuel M.; Paiva, Ricardo Calil; Lopes, Hugo Belotti; Sousa, Amanda G. M. R. [Instituto Dante Pazzanese de Cardiologia, São Paulo, SP (Brazil)

    2013-11-15

    Aging and atherosclerosis are related to renovascular hypertension in elderly individuals. Regardless of comorbidities, renal artery stenosis is itself an important cause of cardiovascular morbidity and mortality. To define the sensitivity, specificity, positive predictive value, and negative predictive value of noninvasive imaging tests used in the diagnosis of renal artery stenosis. In a group of 61 patients recruited, 122 arteries were analized, thus permitting the definition of sensitivity, specificity, and the relative contribution of each imaging study performed (Doppler, scintigraphy and computed tomographic angiography in comparison to renal arteriography). The mean age was 65.43 years (standard deviation: 8.7). Of the variables related to the study population that were compared to arteriography, two correlated with renal artery stenosis, renal dysfunction and triglycerides. The median glomerular filtration rate was 52.8 mL/min/m{sup 2}. Doppler showed sensitivity of 82.90%, specificity of 70%, a positive predictive value of 85% and negative predictive value of 66.70%. For tomography, sensitivity was 66.70%, specificity 80%, positive predictive value 87.50% and negative predictive value 55.20%. With these findings, we could identify the imaging tests that best detected stenosis. Tomography and Doppler showed good quality and efficacy in the diagnosis of renal artery stenosis, with Doppler having the advantage of not requiring the use of contrast medium for the assessment of a disease that is common in diabetics and is associated with renal dysfunction and severe left ventricular dysfunction.

  9. Effect of Lowering Asymmetric Dimethylarginine (ADMA on Vascular Pathology in Atherosclerotic ApoE-Deficient Mice with Reduced Renal Mass

    Directory of Open Access Journals (Sweden)

    Johannes Jacobi

    2014-03-01

    Full Text Available The purpose of the work was to study the impact of the endogenous nitric oxide synthase (NOS inhibitor asymmetric dimethylarginine (ADMA and its degrading enzyme, dimethylarginine dimethylaminohydrolase (DDAH1, on atherosclerosis in subtotally nephrectomized (SNX ApoE-deficient mice. Male DDAH1 transgenic mice (TG, n = 39 and C57Bl/6J wild-type littermates (WT, n = 27 with or without the deletion of the ApoE gene underwent SNX at the age of eight weeks. Animals were sacrificed at 12 months of age, and blood chemistry, as well as the extent of atherosclerosis within the entire aorta were analyzed. Sham treated (no renal mass reduction ApoE-competent DDAH1 transgenic and wild-type littermates (n = 11 served as a control group. Overexpression of DDAH1 was associated with significantly lower ADMA levels in all treatment groups. Surprisingly, SNX mice did not exhibit higher ADMA levels compared to sham treated control mice. Furthermore, the degree of atherosclerosis in ApoE-deficient mice with SNX was similar in mice with or without overexpression of DDAH1. Overexpression of the ADMA degrading enzyme, DDAH1, did not ameliorate atherosclerosis in ApoE-deficient SNX mice. Furthermore, SNX in mice had no impact on ADMA levels, suggesting a minor role of this molecule in chronic kidney disease (CKD in this mouse model.

  10. Strategies for Reducing Respiratory Motion Artifacts in Renal Perfusion Imaging with Arterial Spin Labeling

    OpenAIRE

    Robson, Philip M.; Madhuranthakam, Ananth J.; Dai, Weiying; Pedrosa, Ivan; Rofsky, Neil M.; Alsop, David C.

    2009-01-01

    Arterial Spin Labeling (ASL) perfusion measurements may have many applications outside the brain. In the abdomen, severe image-artifacts can arise from motions between acquisitions of multiple signal averages in ASL, even with single-shot image-acquisition. Background suppression and respiratory motion synchronization techniques can be used to ameliorate these artifacts. Two separate in-vivo studies of renal perfusion imaging using pulsed-continuous ASL were performed. The first study assesse...

  11. Renal Artery Embolization - A First Line Treatment Option For End-Stage Hydronephrosis

    International Nuclear Information System (INIS)

    Conventionally poorly functioning hydronephrotic kidneys have been removed if they are symptomatic. In our unit, patients are offered renal artery embolization as an alternative treatment option. Patients and Methods: Fifteen patients (11 male, 4 female) with a mean age of 32.9 yr (20-51 yrs) have undergone renal artery embolization for symptomatic hydronephrosis with poor function. Mean follow-up was 64.13 weeks (range 14-200). All patients had loin pain and hydronephrosis. Twelve patients had primary pelvi-ureteric junction obstruction (PUJO). Two patients had poorly functioning hydronephrotic kidneys secondary to chronic calculous obstruction. One patient had chronic pain in an obstructed but reasonably functioning kidney following a previous pyeloplasty for PUJO which demanded intervention. Mean split function on renography was 11% (range 0-46%). Selective renal artery embolization was carried out under antibiotic cover using a 7 Fr balloon occlusion catheter and absolute alcohol, steel coils, and polyvinyl alcohol particles.Results: Nine patients developed post-embolization syndrome of self-limiting pain and pyrexia with no evidence of sepsis. One patient required readmission with this condition. One patient developed a hematoma at the puncture site. Mean hospital stay was 2.3 days. Fourteen patients are happy with the result and are completely pain free. One patient has minor discomfort but is delighted with the result. Nine patients have had follow-up ultrasound confirming resolution of the hydronephrosis. Conclusion: Renal artery embolization is an effective, safe, well-tolerated minimally invasive treatment option in end-stage hydronephrosis and we routinely offer it as an alternative to nephrectomy

  12. Transplant renal artery stenosis secondary to mechanical compression from polycystic kidney disease: A case report

    OpenAIRE

    Lee, Linda; Gunaratnam, Lakshman; Sener, Alp

    2013-01-01

    Transplant renal artery stenosis (TRAS) is a potentially treatable cause of allograft dysfunction, hypertension and graft loss. The mainstay of treatment includes angioplasty and endovascular stenting, although observation and surgery are at times indicated. We present an unusual case of TRAS secondary to mechanical compression from a patient’s enlarged native polycystic kidneys. This was treated with bilateral native nephrectomy and evidence of TRAS improved both clinically and radiographica...

  13. Risk factors for deterioration of renal function after coronary artery bypass grafting

    OpenAIRE

    van Straten, Albert; Hamad, Mohamed; Van Zundert, Adrien; Martens, Elisabeth; Schönberger, Jacques; de Wolf, Andre

    2010-01-01

    Abstract Objective: Various definitions of impairment of renal function after coronary artery bypass grafting (CABG) are used in the literature. Depending on the definition, several risk factors are identified. We analysed our data to determine the risk factors for postoperative deterioration of the creatinine clearance of 10% or more. Methods: All patients undergoing isolated coronary surgery in a single centre between January 1998 and December 2007 are included. Clinical data, including ...

  14. USO DE LA ECOGRAFÍA RENAL EN EL ESTUDIO DE LA HIPERTENSIÓN ARTERIAL.

    OpenAIRE

    Gerardo Torres Torres MD; Santiago Pascual Carrasco MD,; Raquel De Toro Casado MD; María Luisa Carrasco Prados MD; Basilia González Díaz MD; Javier Santos Barajas MD PhD; Pedro Abáigar Luquín MD PhD; Pilar Vicente Cobos MD

    2004-01-01

    Sonography has become accessible, easy to make and non-aggressive investigation which has been used commonly in clinical practice. Main aim of this study was to evaluate a clinical value of renal ultrasound in patients presenting arterial hypertension, the study was designed as a transversal, and retrospective on selected hypertensive patients. A clinical diagnostic of 236 patients with hypertension was review, 205 of them fulfilled diagnostic criteria of essential hypertension and 31 pati...

  15. Endovascular Management of True Renal Arterial Aneurysms: Results from a Single Centre

    Energy Technology Data Exchange (ETDEWEB)

    Chung, Raymond, E-mail: chung.raymond.jh@alexandrahealth.com.sg [Khoo Teck Puat Hospital, Department of Radiology (Singapore); Touska, Philip, E-mail: p.touska@doctors.org.uk [St. George’s Hospital NHS Trust, Department of Radiology (United Kingdom); Morgan, Robert; Belli, Anna-Maria [St. George’s Hospital NHS Trust, Department of Interventional Radiology (United Kingdom)

    2016-01-15

    PurposeTo report a single centre’s experience of the endovascular treatment of renal arterial aneurysms, including techniques and outcomes.Materials and MethodsThis is a retrospective analysis of true renal arterial aneurysms (TRAAs) treated using endovascular techniques over a period of 12 years and 10 months. The clinical presentations, aneurysm characteristics, endovascular techniques and outcomes are reported.ResultsThere were nine TRAA cases with a mean aneurysm size of 21.0 mm, located at the main renal arterial bifurcation in all cases. Onyx{sup ®} was used as the embolic agent of choice (88.9 % cases), with concurrent balloon remodelling. The overall primary technical success rate was 100 %. Repeat intervention was carried out in 1 case, secondary to reperfusion >8 years post-initial treatment. Long-term clinical follow-up was available in 55.6 % of cases (mean 29.8 months; range 3.3–90.1 months). Early post-procedural renal function, as measured by serum creatinine, remained within the normal reference range. Renal parenchymal loss post-embolisation was ≤20 % in 77.8 % of cases, as estimated on imaging. Minor complications included non-target embolization of Onyx{sup ®} with no clinical sequelae (n = 1), transient pain requiring only oral analgesia with no prolongation of hospital stay (n = 2). No major complications occurred as a consequence of embolisation.ConclusionEndovascular therapy is an effective and safe primary therapy for TRAA with high success rate and low morbidity, supplanting surgery as primary therapy. Current experience in the use of Onyx{sup ®} in TRAA is primarily limited to individual case reports, and this represents the largest case series of Onyx{sup ®}-treated TRAAs to date.

  16. Endovascular Management of True Renal Arterial Aneurysms: Results from a Single Centre

    International Nuclear Information System (INIS)

    PurposeTo report a single centre’s experience of the endovascular treatment of renal arterial aneurysms, including techniques and outcomes.Materials and MethodsThis is a retrospective analysis of true renal arterial aneurysms (TRAAs) treated using endovascular techniques over a period of 12 years and 10 months. The clinical presentations, aneurysm characteristics, endovascular techniques and outcomes are reported.ResultsThere were nine TRAA cases with a mean aneurysm size of 21.0 mm, located at the main renal arterial bifurcation in all cases. Onyx® was used as the embolic agent of choice (88.9 % cases), with concurrent balloon remodelling. The overall primary technical success rate was 100 %. Repeat intervention was carried out in 1 case, secondary to reperfusion >8 years post-initial treatment. Long-term clinical follow-up was available in 55.6 % of cases (mean 29.8 months; range 3.3–90.1 months). Early post-procedural renal function, as measured by serum creatinine, remained within the normal reference range. Renal parenchymal loss post-embolisation was ≤20 % in 77.8 % of cases, as estimated on imaging. Minor complications included non-target embolization of Onyx® with no clinical sequelae (n = 1), transient pain requiring only oral analgesia with no prolongation of hospital stay (n = 2). No major complications occurred as a consequence of embolisation.ConclusionEndovascular therapy is an effective and safe primary therapy for TRAA with high success rate and low morbidity, supplanting surgery as primary therapy. Current experience in the use of Onyx® in TRAA is primarily limited to individual case reports, and this represents the largest case series of Onyx®-treated TRAAs to date

  17. The Risk of Peripheral Arterial Disease after Parathyroidectomy in Patients with End-Stage Renal Disease

    Science.gov (United States)

    Chen, Hsuan-Ju; Li, Tsai-Chung; Hsu, Chih-Cheng; Kao, Chia-Hung

    2016-01-01

    Purpose The changes of the risk of peripheral arterial disease (PAD) in patients with end-stage renal disease after parathyroidectomy are scant. Methods We used a nationwide health insurance claims database to select all dialysis-dependent patients with end-stage renal disease aged 18 years and older for the study population in 2000 to 2006. Of the patients with end-stage renal disease, we selected 947 patients who had undergone parathyroidectomy as the parathyroidectomy group and frequency matched 3746 patients with end-stage renal disease by sex, age, years since the disease diagnosis, and the year of index date as the non-parathyroidectomy group. We used a multivariate Cox proportional hazards regression analysis with the use of a robust sandwich covariance matrix estimate, accounting for the intra-cluster dependence of hospitals or clinics, to measure the risk of peripheral arterial disease for the parathyroidectomy group compared with the non-parathyroidectomy group after adjusting for sex, age, premium-based income, urbanization, and comorbidity. Results The mean post-op follow-up periods were 5.08 and 4.52 years for the parathyroidectomy and non-parathyroidectomy groups, respectively; the incidence density rate of PAD in the PTX group was 12.26 per 1000 person-years, significantly lower than the data in the non-PTX group (24.09 per 1000 person-years, adjusted HR = 0.66, 95% CI = 0.46–0.94). Conclusion Parathyroidectomy is associated with reduced risk of peripheral arterial disease in patients with end-stage renal disease complicated with severe secondary hyperparathyroidism. PMID:27284924

  18. Renal Artery Stenting Using CO2 Gas Angiography in Combination with Iodinated Contrast Angiography.

    Science.gov (United States)

    Adachi, Yuya; Endo, Akihiro; Nakashima, Ryuma; Sugamori, Takashi; Takahashi, Nobuyuki; Kinoshita, Yoshihisa; Tanabe, Kazuaki

    2016-01-01

    A 76-year-old woman was hospitalized repeatedly due to unexplained heart failure. On admission, she had hypertensive acute heart failure. Her symptoms disappeared promptly after the initial treatment; however, her systolic blood pressure remained at over 160 mmHg despite her taking three antihypertensive drugs. Closer examination revealed hemodynamically significant right renal artery stenosis and a lack of left kidney function. We performed percutaneous transluminal renal angioplasty using CO2 angiography in combination with iodinated contrast agents. The patient's renal function and blood pressure improved, however, CO2 gas-induced mild ischemic colitis occurred. We discuss the possibility of the use of combined iodinated contrast angiography and CO2 angiography to avoid contrast-induced nephropathy and the complications peculiar to CO2 angiography. PMID:27580543

  19. Reduction of the incidence of post-transplant renal artery stenosis associated with local graft irradiation

    International Nuclear Information System (INIS)

    The authors report the results of 170 sequential renal transplantations performed at Georgetown University Hospital from 1978 until 1982. All patients were treated with an uniform regimen consisting of azathioprine, prednisone, dypyridamole, and local graft irradiation (LGI). No cases of renal artery stenosis (RAS) have been found among the 170 transplants despite an expectant incidence based upon previously published reports of 4.5%(p=.01). They hypothesize that LGI soon after transplantation leads to a temporary inhibition of fibroblast growth and smooth muscle cell proliferation within the renal vessel wall aborting future stenotic lesions. The effect is comparable to keloid prevention by irradiation. Correlation with fibroblast radiation survival curves lends support to this hypothesis

  20. Impact of arterial occlusion during partial nephrectomy on residual renal function. An evaluation with 99mtechnetium-dimercaptosuccinic acid scintigraphy

    International Nuclear Information System (INIS)

    Partial nephrectomy (PNx) has been performed with temporary renal arterial occlusion and in situ renal hypothermia (conventional PNx). However, the impact of temporary renal arterial occlusion on residual renal function has not been well assessed. To address this question, we performed renal scintigraphy with 99mtechnetium-dimercaptosuccinic acid (DMSA) for the quantitative measurement of postoperative residual renal function after conventional PNx and partial nephrectomy without arterial occlusion (non-clamping PNx). Thirty-four patients underwent postoperative DMSA scintigraphy after PNx for renal cell carcinoma. No obvious difference in preoperative renal function between the diseased kidney and the contralateral kidney was found in any of the patients. Of these patients, 24 underwent conventional PNx, and 10 underwent non-clamping PNx. Residual renal function was evaluated using the relative DMSA uptake of the operated kidney. The relative DMSA uptake of the operated kidney was 39.9±7.3% (25.1-58.8) after conventional PNx compared to 34.8±8.9% (13.5-45.5) after non-clamping PNx. This difference was not statistically significant (P=0.15). Total ischemic time during conventional PNx had no adverse influence on the residual renal function. In the analysis of the other determinant factors influencing residual renal function, tumor size was the only significant factor that inversely correlated with the relative DMSA uptake. Our results showed that arterial clamping during PNx has no negative impact on the functional residual capacity as long as in situ renal hypothermia is adequately performed. (author)

  1. Prevalence of renal artery stenosis in flash pulmonary oedema: determination using gadolinium-enhanced MRA.

    LENUS (Irish Health Repository)

    McMahon, Colm J

    2012-02-01

    PURPOSE: The primary purpose was to determine the prevalence of renal artery stenosis (RAS) in patients presenting with acute ("flash") pulmonary oedema (FPE), without identifiable cause using contrast-enhanced magnetic resonance angiography (CE-MRA) of renal arteries. A secondary goal was to correlate clinical parameters at presentation with the presence or absence of RAS. MATERIALS AND METHODS: Patients presenting with acute pulmonary oedema without identifiable cause prospectively underwent CE-MRA. >50% renal artery stenosis was considered significant. Clinical parameters (blood pressure, serum creatinine, history of hypertension\\/hyperlipidaemia) were compared in patients with and without RAS using an unpaired t-test. Results expressed; mean (+\\/-SD). RESULTS: 20 patients (4 male, 16 female, age 78.5+\\/-11 years) underwent CE-MRA. 9 patients (45%) had significant RAS (6 (30%) bilateral, 3 (15%) unilateral). Systolic BP was higher in patients with RAS (192+\\/-38 mm Hg) than those without (134+\\/-30 mm Hg) (p<.005). Diastolic BP was higher in patients with RAS (102+\\/-23 mm Hg) than those without (76+\\/-17 mm Hg) (p<.01). All patients with RAS and 6\\/11(55%) patients without RAS had a history of hypertension. No significant difference in creatinine or hyperlipidaemia history was observed. CONCLUSION: The prevalence of RAS in patients presenting with FPE is 45%. The diagnosis should be considered in patients presenting with unexplained acute pulmonary oedema, particularly if hypertensive at presentation.

  2. Renal angiomyolipoma : superselective arterial embolization and long term follow-up

    International Nuclear Information System (INIS)

    To evaluate the effectiveness of superselective arterial embolization in symptomatic renal angiomyolipoma by assessing tumoral changes and clinical symptoms in long term follow up after embolization For the treatment of their condition, nine patients with symptomatic renal angiomyolipoma underwent ten superselective arterial embolization procedures. In all patients, angiomyolipoma had been diagnosed by computed tomography(CT), and in two, had been confirmed by ultrasonography-guided aspiration biopsy. The embolic materials used were absolute alcohol in four sessions, absolute alcohol mixed with lipiodol in three, and Giantruco coils in three. In all patients, follow-up after embolization lasted for between 12 and 54 months, and involved the use of CT. We reviewed retrospectively patients' clinical symptoms, and changes in the size and internal components of tumors, as seen on preembolization and postembolization CT scans. On postembolization angiography, devascularization of the tumor was seen in all patients; the initial symptoms disappeared and tumor size decreased during the follow up period. In nine patients, tumor size decreased after embolization by between 26 and 92%. During the long term (over 12 months) follow up of all patients, seven tumors with a considerable angiomyogenic component markedly decreased in size, but tumors in which the mature fatty component was substantial became only slightly smaller. Reembolization was performed in one patient. Superselective arterial embolization is effective in the management of symptomatic renal AML; during long-term follow-up, tumors became smaller and clinical symptoms improved. Embolization is more effective in tumors in which the angiomyogenic component is large

  3. MR-guided coil embolisation of renal arteries in an animal model

    International Nuclear Information System (INIS)

    Purpose: To test the feasibility of MR-guided coil embolization with passive visualization in an animal model. Materials and Methods: All experiments were performed on a 1.5 T interventional MR-scanner (Gyroscan ACS-NT, Philips, Netherlands). A gradient echo sequence was combined with radial k-space acquisition and sliding window reconstruction technique to calculate the raw data with a specially designed back projector, yielding a frame rate of 20 images per second. The images were directly displayed on LCD-screens next to the MR scanner. A multipurpose catheter with dysprosium markers was placed into the renal arteries of two pigs under MR guidance, and a nitinol coil and platinum coil each were deployed. The position of the coils was verified with magnetic resonance angiography and conventional angiography. Results: MR-guided catheterization of renal arteries with subsequent coil embolization was successfully carried out but the configuration of the coils could not be visualized on the MR images. Conclusion: MR-guided coil embolization of renal arteries is feasible. Exact guidance of coil deployment is not attainable with passive visualization. (orig.)

  4. Therapeutic embolization of renal artery to control severe hypertension due to renal trauma

    International Nuclear Information System (INIS)

    In a young patient with a post-traumatic renal hematoma, severe systemic hypertension, secondary to the activation of the renin-angiotensin axis, developed. Because of persistent hypertension, after 3 months of drug therapy, selective percutaneous embolization of the damaged vessels was performed. One year after procedure, the patient is normotensive without drugs. (orig.)

  5. Intracranial Atherosclerotic Disease

    Directory of Open Access Journals (Sweden)

    Maria Khan

    2011-01-01

    Full Text Available Intracranial atherosclerotic disease (ICAD is the most common proximate mechanism of ischemic stroke worldwide. Approximately half of those affected are Asians. For diagnosis of ICAD, intra-arterial angiography is the gold standard to identify extent of stenosis. However, noninvasive techniques including transcranial ultrasound and MRA are now emerging as reliable modalities to exclude moderate to severe (50%–99% stenosis. Little is known about measures for primary prevention of the disease. In terms of secondary prevention of stroke due to intracranial atherosclerotic stenosis, aspirin continues to be the preferred antiplatelet agent although clopidogrel along with aspirin has shown promise in the acute phase. Among Asians, cilostazol has shown a favorable effect on symptomatic stenosis and is of benefit in terms of fewer bleeds. Moreover, aggressive risk factor management alone and in combination with dual antiplatelets been shown to be most effective in this group of patients. Interventional trials on intracranial atherosclerotic stenosis have so far only been carried out among Caucasians and have not yielded consistent results. Since the Asian population is known to be preferentially effected, focused trials need to be performed to establish treatment modalities that are most effective in this population.

  6. Three dimensional level set based semiautomatic segmentation of atherosclerotic carotid artery wall volume using 3D ultrasound imaging

    Science.gov (United States)

    Hossain, Md. Murad; AlMuhanna, Khalid; Zhao, Limin; Lal, Brajesh K.; Sikdar, Siddhartha

    2014-03-01

    3D segmentation of carotid plaque from ultrasound (US) images is challenging due to image artifacts and poor boundary definition. Semiautomatic segmentation algorithms for calculating vessel wall volume (VWV) have been proposed for the common carotid artery (CCA) but they have not been applied on plaques in the internal carotid artery (ICA). In this work, we describe a 3D segmentation algorithm that is robust to shadowing and missing boundaries. Our algorithm uses distance regularized level set method with edge and region based energy to segment the adventitial wall boundary (AWB) and lumen-intima boundary (LIB) of plaques in the CCA, ICA and external carotid artery (ECA). The algorithm is initialized by manually placing points on the boundary of a subset of transverse slices with an interslice distance of 4mm. We propose a novel user defined stopping surface based energy to prevent leaking of evolving surface across poorly defined boundaries. Validation was performed against manual segmentation using 3D US volumes acquired from five asymptomatic patients with carotid stenosis using a linear 4D probe. A pseudo gold-standard boundary was formed from manual segmentation by three observers. The Dice similarity coefficient (DSC), Hausdor distance (HD) and modified HD (MHD) were used to compare the algorithm results against the pseudo gold-standard on 1205 cross sectional slices of 5 3D US image sets. The algorithm showed good agreement with the pseudo gold standard boundary with mean DSC of 93.3% (AWB) and 89.82% (LIB); mean MHD of 0.34 mm (AWB) and 0.24 mm (LIB); mean HD of 1.27 mm (AWB) and 0.72 mm (LIB). The proposed 3D semiautomatic segmentation is the first step towards full characterization of 3D plaque progression and longitudinal monitoring.

  7. Renal dysfunction and state of metabolic and hemodynamic factors in patients with arterial hypertension

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    Klochkov V.A.

    2011-12-01

    Full Text Available The aim of the investigation is to carry out comparative evaluation of metabolic and hemodynamic indices in patients with arterial hypertension (AH and renal dysfunction; to study the interrelation between arterial blood pressure level normalization and the presence or lack of microalbuminuria (MAU in the morning urine portion of patients with AH after therapy with antihypertensive preparations (APs of various groups. Methods. 121 persons have been investigated, 91 out — patients of both sexes, aged 33-55, with the diagnosis of arterial hypertension of stage II risk III, who have been taking Perindopril, Telmisartan and Bisoprolol for3 months. The control of arterial pressure level, biochemical analysis of metabolic indices and morning urine portion test for microalbuminuria has been carried out. Results. MAU has been revealed in 17,6% patients, occurring more frequently in men than in women. Microalbuminuria is accompanied by reliable decrease of total and ionized calcium and magnesium concentrations, an increase of potassium level in blood plasma, increase of cholesterol, triglycerides, glucose and levels. Patients with AH and renal dysfunction reliably demonstrate higher levels of systolic and diastolic arterial pressure in the morning and evening hours, their normalization effect after APs intake is significantly interconnected with MAU presence. Conclusion. In patients with AH and MAU the main risk factors of cardio-vascular diseases development are more expressed. Microalbuminuria is a risk factor in patients with arterial hypertension and may influence on the basic blood electrolyte balance. While carrying out antihypertensive therapy the presence of MAU should be taken into consideration

  8. Blunt renal trauma: comparison of contrast-enhanced CT and angiographic findings and the usefulness of transcatheter arterial embolization

    International Nuclear Information System (INIS)

    Full text: Background: The purpose of this study was to evaluate the role of contrast-enhanced CT and the usefulness of super selective embolization therapy in the management of arterial damage in patients with severe blunt renal trauma. Patients and Methods: Nine cases of severe renal trauma were evaluated. In all cases, we compared contrast enhanced CT findings with angiographic findings, and performed transcatheter arterial embolization (TAE) in six of them with microcoils and gelatin sponge particles. Morphological changes in the kidney and site of infarction after TAE were evaluated on follow-up CT Chronological changes in blood biochemistry findings after injury, degree of anemia and renal function were investigated. Adverse effects or complications such as duration of hematuria, fever, abdominal pain, renovascular hypertension and abscess formation were also evaluated. Results: The CT finding of extravasation was a reliable sign of active bleeding and useful for determining the indication of TAE. In all cases, bleeding was effectively controlled with super selective embolization. There was minimal procedure-related loss of renal tissue. None of the patients developed abscess, hypertension or other complications. Conclusions: In blunt renal injury, contrast-enhanced CT was useful for diagnosing arterial hemorrhage. Arterial bleeding may produce massive hematoma and TAE was a useful treatment for such cases. By using selective TAE for a bleeding artery, it was possible to minimize renal parenchymal damage, with complications of TAE rarely seen. (author)

  9. Blunt renal trauma: comparison of contrast-enhanced CT and angiographic findings and the usefulness of transcatheter arterial embolization

    Energy Technology Data Exchange (ETDEWEB)

    Kitase, M.; Mizutani, M.; Tomita, H.; Kono, T.; Sugie, C.; Shibamoto, Y. [Nagoya City University, Nagoya, (Japan). Graduate School of Medical Sciences. Dept. of Radiology

    2007-07-15

    Full text: Background: The purpose of this study was to evaluate the role of contrast-enhanced CT and the usefulness of super selective embolization therapy in the management of arterial damage in patients with severe blunt renal trauma. Patients and Methods: Nine cases of severe renal trauma were evaluated. In all cases, we compared contrast enhanced CT findings with angiographic findings, and performed transcatheter arterial embolization (TAE) in six of them with microcoils and gelatin sponge particles. Morphological changes in the kidney and site of infarction after TAE were evaluated on follow-up CT Chronological changes in blood biochemistry findings after injury, degree of anemia and renal function were investigated. Adverse effects or complications such as duration of hematuria, fever, abdominal pain, renovascular hypertension and abscess formation were also evaluated. Results: The CT finding of extravasation was a reliable sign of active bleeding and useful for determining the indication of TAE. In all cases, bleeding was effectively controlled with super selective embolization. There was minimal procedure-related loss of renal tissue. None of the patients developed abscess, hypertension or other complications. Conclusions: In blunt renal injury, contrast-enhanced CT was useful for diagnosing arterial hemorrhage. Arterial bleeding may produce massive hematoma and TAE was a useful treatment for such cases. By using selective TAE for a bleeding artery, it was possible to minimize renal parenchymal damage, with complications of TAE rarely seen. (author)

  10. The diagnostic value of mean platelet volume in males with premature atherosclerotic coronary artery disease having stable angina pectoris

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    Özgül Malçok Gürel

    2014-09-01

    Full Text Available Objective: In this study, we aimed to investigate whether platelet count and mean platelet volume (MPV could be new biomarkers addition to classical risk factors in premature coronary artery disease (CAD. Methods: Totally 124 male patients (mean age: 45.8±13.0 year; range of age: 27-78 year, with stable angina pectoris, were included. Clinical and laboratory findings (whole blood cell count, glucose, creatinine, lipid profile were recorded. Automatic blood counter was used for hematological parameters. Conventional coronary angiography was performed. Patients having acute coronary syndrome within the last six months, with severe valvular, structural or congenital heart disease, thyroid and hepatic dysfunction or signs of any infection were excluded. Results: The study population were separated into three groups by coronary angiography: 51 with stable CAD aged ≤40 years (premature CAD, 38 with stable CAD older than 40 (mature CAD and 35 with the normal coronary arteries (NCA. No significant difference was found in MPV values between premature CAD and mature CAD and also between premature CAD and NCA (p>0.05. A significant negative correlation was found between MPV and platelet count in premature CAD (r=-0.419, p=0.002. Both in premature CAD and mature CAD groups, higher MPV values was found in critical CAD subgroup than noncritical CAD subgroup, but the difference was not statistically significant (p>0.05. Conclusion: There was no significant difference in MPV between premature and mature male CAD patients compared to NCA group. A positive but non-significant correlation was found between the MPV values and the severity of CAD. J Clin Exp Invest 2014; 5 (3: 381-385

  11. [Late complication of selective renal arterial embolization after percutaneous surgery: renal "colic"].

    Science.gov (United States)

    Savoie, Pierre-Henri; Lafolie, Trévor; Gabaudan, Charline; Biance, Nicolas; Avaro, Jean-Philippe; André, Marc; Bertrand, Serge; Balandraud, Paul

    2007-06-01

    Authors report a case of a 31 years old patient who eliminate a urinary stone which contains a platinium coil. Five years ago, this patient had a percutaneous nephrolithotomy. A persistent hematuria was successfully managed with angioembolization of a lower polar artery branch. One of the coils was deployed too distally. It was not efficient, it rolled itself up in the pseudoaneurysm cavity. Different physio pathological hypothesis are developed to explain this expulsion. PMID:17634005

  12. Transcatheter embolization with N-butyl cyanoacrylate for renal arterial bleeding

    International Nuclear Information System (INIS)

    Objective: To discuss the effectiveness and safety of transcatheter embolization with N- butyl cyanoacrylate (NBCA) in treating renal artery bleeding. Methods: During the period from Jan. 2006 to June 2013, transcatheter embolization with NBCA was carried out in 12 patients with renal arterial bleeding, who failed to respond to the conventional treatment. Of the 23 patients, only NBCA was used in 20 (80%), and NBCA together with Gelfoam and/or micro-coils was employed in 3 (13%). DSA showed that the lesions included pseudoaneurysm (n=10), arteriovenous fistula (n=8) and active bleeding (n=5). The clinical and imaging materials were retrospectively analyzed. The technical success rate, clinical result and procedure-related complications were recorded. Results: Technical success was obtained in all 23 patients. Angiography performed after the transcatheter embolization showed that the abnormal vascular manifestations disappeared in all cases. The bleeding stopped at 2 or 3 days after the procedure, and no recurrence was observed. No obvious complications occurred during and after the treatment. Conclusion: For renal bleeding due to various reasons, transcatheter embolization with NBCA only or with NBCA plus other embolic materials is safe and effective. Even for patients with poor coagulation function, NBCA can also get satisfactory result. (authors)

  13. Evaluation of transplant renal artery stenosis examined by multislice spiral CT angiograph

    International Nuclear Information System (INIS)

    Objective: To evaluate the value of multislice CT angiography (MSCTA) in transplant renal artery stenosis (TRAS). Methods: Fifteen cases of TRAS underwent enhanced MSCT scanning postoperation. Multi-planar reformation (MPR), CPR (curved-planar reformation), volume rendering (VR), multi-planar volume reformation (MPVR), maximum intensity projection (MIP) and vessel probe (VP) reformation were performed to observe transplant kidney's artery. To analyse all the reconstruction technique and find the advantage and shortage of them. Results: CT findings of TRAS showed local vascular thining and enhanced renal parenchyma degradinged. CT reconstruction technique: 1 Trans-plant kidney's artery of only one case could be shown in the same MPR plane; 2 Transplant kidney's artery of 13 cases could be shown in CPR coronal and sagittal plane; 3 with 15 cases of VR, stage of courser and shape of angiostegnosis could be observed clearly through rotating the reconstruction image from different directions; 4 15 cases of MPVR could reveal transplant kidney's artery and TRAS at the same time; 5 9 cases of MIP could show TRAS in one plane; 6 15 cases of VP could show condition inside the vessel of transplant kidney, with the degree of stenosis appeared clearly. Of 15 cases of TRAS, stenosis occurred in stoma (8 cases), distant place from stoma (4 cases), stoma and distant place form stoma (2 cases), stenosis occurred in whole range (oe case). Conclusion: MSCTA has an important role as an imaging technique to evaluate TRAS of transplant kidney, which can replace DSA. It can reveal the stenosis part of vessel and direct PTA, to evaluate therapeutic effect of endovascular stent placement. MSCTA will be widespread used clinically. (authors)

  14. Distribution of ultrasonic radiofrequency signal amplitude detects lipids in atherosclerotic plaque of coronary arteries: an ex-vivo study

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    Moroi Masao

    2008-05-01

    Full Text Available Abstract Background Accumulation of lipids within coronary plaques is an important process in disease progression. However, gray-scale intravascular ultrasound images cannot detect plaque lipids effectively. Radiofrequency signal analysis could provide more accurate information on preclinical coronary plaques. Methods We analyzed 29 zones of mild atheroma in human coronary arteries acquired at autopsy. Two histologic groups, i.e., plaques with a lipid core (group L and plaques without a lipid core (group N, were analyzed by automatic calculation of integrated backscatter. One hundred regions of interest were set on the target zone. Radiofrequency signals from a 50 MHz transducer were digitized at 240 MHz with 12-bit resolution. The intensity of integrated backscatter and its distribution within each plaque were compared between the two groups. Results Although the mean backscatter was similar between the groups, intraplaque variation of backscatter and backscatter in the axial direction were larger in group L than in group N (p = 0.02. Conventional intravascular ultrasound showed extremely low sensitivity for lipid detection, despite a high specificity. In contrast, a cut-off value>32 for the total variance of integrated backscatter identified lipid-containing plaque with a high sensitivity (85% and specificity (75%. Conclusion Compared with conventional imaging, assessment of the intraplaque distribution of integrated backscatter is more effective for detecting lipid. As coronary atheroma progresses, its composition becomes heterogeneous and multi-layered. This radiofrequency technique can portray complex plaque histology and can detect the early stage of plaque progression.

  15. Post re-anastomosis demonstration of regain in function in non-visualized upper half of kidney in a dual arterial allogenic renal graft on renal scintigraphy

    International Nuclear Information System (INIS)

    A young male patient with end stage renal disease underwent renal allograft having dual arterial supply. Immediate post-operative urine output dropped, an urgent Technetium-99m-mercaptoacetyltriglycine (99mTc-MAG3) renogram revealed non-visualized upper-half and the preserved perfusion and parenchymal function of the small transplant kidney. Patient was re-explored and re-anastomosis was performed. A renogram at 24h post re-anastomosis revealed increase in the size of renal allograft, with preserved perfusion to the upper-half of transplant. Transplant kidney biopsy of the Upper-half showed acute tubular necrosis. 99mTc-MAG3renogram at 10 days post re-vascularization remains unchanged with persistent improvement at 2 months follow-up. We conclude that early recognition of renal functional loss allows early management and the high probability of salvaging the renal function

  16. Restoration of glomerular haemodynamics and renal injury independent of arterial hypertension in rats with subtotal renal ablation.

    Science.gov (United States)

    Herrera-Acosta, Jaime; Tapia, Edilia; Sánchez-Lozada, Laura G; Franco, Martha; Striker, Liliane J; Striker, Gary E; Rodríguez, Iturbe Bernardo

    2002-06-01

    To study whether prevention of renal injury using the anti-inflammatory drugs pentosan polysulphate (PPS) and mycophenolate mofetil (MMF) is associated with improvement of glomerular haemodynamics, PPS and MMF were compared with losartan. The awake systolic blood pressure (SBP), proteinuria (Uprot) and micropuncture studies were performed 30 days after five-sixths nephrectomy in untreated rats and in rats treated with PPS (100 mg/kg per day), MMF (30 mg/kg per day) or losartan (30 mg/kg per day). In the rats receiving no treatment, there was a rise in SBP (to 180-200 mmHg) and in Uprot, which were prevented by losartan. In the PPS and MMF groups, the SBP was elevated but the Uprot did not increase. In the untreated rats the total glomerular filtration rate (GFR) decreased (-80%) and the single-nephron GFR (37-42%), plasma flow (67-127%) and glomerular pressure (10-15 mmHg) increased. These changes were prevented by PPS and MMF to the same extent as by losartan: the rise in single-nephron GFR and plasma flow were reduced by 50% and the glomerular pressure was normal. In rats receiving losartan, this was due to the fall in arterial pressure, whereas in PPS- and MMF-treated rats it was due to a rise in afferent resistance, indicating autoregulatory capacity. Total GFR was similar, despite the lower single-nephron GFR in treated groups, suggesting a larger proportion of functioning nephrons. Losartan, PPS and MMF significantly reduced glomerular sclerosis and tubular dilation and atrophy in association with a reduction in the lymphocyte and macrophage infiltrate. These results suggest an interaction between the haemodynamic and inflammatory changes that perpetuate each other during progression of renal injury. Renal protection provided by anti-inflammatory drugs is partially mediated by the prevention of glomerular haemodynamic alterations. PMID:12184053

  17. Analysis of Renal Artery Stenosis in Patients with Heart Failure: A RASHEF Study

    Institute of Scientific and Technical Information of China (English)

    Bin Zheng; Qin Ma; Li-Hong Zheng; Qiang Yong; Yi-Hua He; Jing-Hua Liu

    2015-01-01

    Background:Previous data are controversial about the association of renal artery stenosis (RAS) with clinical outcome in patients with heart failure.Definition of RAS in previous studies might not be appropriate.By definition of RAS with renal duplex sonography,we investigated the association of RAS with clinical outcome in patients with heart failure.Methods:In this retrospective study,we identified 164 patients with heart failure (New York Heart Association classification ≥Ⅱ;left ventricular ejection fraction <50%) who had received renal duplex sonography during hospital stay.RAS was defined as renal-aortic ratio ≥3.5 or a peak systolic velocity ≥200 cm/s (or both),or occlusion of the renal artery.Categorical data of patients were compared using the Chi-square test or Fisher's exact test.Cox proportional hazards regression modeling technique was used to investigate the prognostic significance of possible predictors.Results:Finally,143 patients were enrolled.Median follow-up time was 32 months (1-53 months).Twenty-two patients were diagnosed as RAS by renal duplex sonography,including 13 unilateral RAS (3 left RAS,10 right RAS) and 9 bilateral RAS.There were more all-cause mortality and cardiovascular death in patients with RAS than patients without RAS.By multivariate analysis,RAS was a significant predictor for all-cause death and cardiovascular death (hazard ratio [HR] =4.155,95% confidence interval [CI]:1.546-11.164,P =0.005;and HR =3.483,95% CI:1.200-10.104,P =0.022,respectively).As for composite endpoint events,including death,nonfatal myocardial infarction,ischemic stroke or intracranial hemorrhage,rehospitalization for cardiac failure,and renal replacement therapy,only angiotensin-converting enzyme inhibitor or angiotensin-receptor blocker was significant predictor.RAS was not a significant predictor for composite endpoint events.Conclusions:Our data suggested that RAS is associated with a poorer clinical outcome in patients with heart

  18. RENOVASCULAR HYPERTENSION DUE TO RENAL ARTERY STENOSIS IN KLIPPEL-FEIL SYNDROME

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    Foyaca-Sibat H. MD.

    2003-01-01

    Full Text Available ABSTRACT We report one patient with Klippel-Feil (KFS syndrome, other associated anomalies, uncontrolled arterial hypertension, and renal artery stenosis. Because this patient underwent for surgical revascularization with unsuccessful result, all proposed way of treatments are revised, and we have hypothesized that probably for patients with KFS and unilateral renal artery stenosis, medical treatment with ACE inhibitors can provide more benefits than surgical revascularization or percutaneous transluminal angioplasty. We considered that those patients should be manage by a team of medical doctors being aware of their common associated anomalies, identifying all of them when it is possible then, making an integral evaluation of the each individual situation for establishing their medical priorities in order, and then address its treatments accordingly. If at this stage any surgical treatment is required, is important to bring those problems to the anesthesiologist’s attention for a very careful manipulation of the neck and head during induction of anesthesia. The final results will be strongly related with the capacity of management of the underlying cardio-respiratory, renal, skeletal, urogenital, and nervous system problems. . We also propose the term of Klippel-Feil syndrome "Plus" for those patients with cervical vertebral fusion and many other associated deformities rather than to add new eponyms to the long list that already exist. _____________ RESUMEN: HIPERTENSION RENOVASCULAR DEBIDO A ESTENOSIS DE LA ARTERIA RENAL EN EL SÍNDROME DE KLIPPEL-FEIL Reportamos un paciente afectado por un syndrome de Klippel-Feil, otras anormalias congenitas, hipertension arterial incontrolada y una estenosis unilateral de la arteria renal. Este paciente fue sometido a un tratamiento quirÚrgico de la estenosis de la arteria renal, cuyos resultados fueron no satisfactorios por lo que revisamos todas las alternativas de tratamiento para la estenosis

  19. Radiotherapy of renal arterial stenosis using percutaneous transluminal angioplasy (PTA) as compared with surgical measures

    International Nuclear Information System (INIS)

    The techniques and findings of percutaneous transluminal angioplasy (PTA) are described. The method was technically applicable in 24 (86%) of 28 cases of renal arterial stenosis. Two clinically quiescent complications are reported. After a mean observation period of 16.7 months, normal blood pressure was recorded in 8 patients, improved blood pressure in 7 patients, and unchanged values in 5 patients. The disturbed renal function observed in 8 patients was found to have returned to normal in 4 cases and improved in 4 cases. PTA is an alternative to surgical revascularisation in the treatment of renovascular hypertension. Owing to its low traumatic effect on the patient, it is recommended as the method of choice. (orig./MG)

  20. Comparative imaging study in ultrasound, MRI, CT, and DSA using a multimodality renal artery phantom

    Energy Technology Data Exchange (ETDEWEB)

    King, Deirdre M.; Fagan, Andrew J.; Moran, Carmel M.; Browne, Jacinta E. [Medical Ultrasound Physics and Technology Group, School of Physics, Dublin Institute of Technology, Dublin 8 (Ireland); Centre for Advanced Medical Imaging (CAMI), St James' s Hospital, Dublin 8 (Ireland); Department of Medical Physics, University of Edinburgh, Edinburgh EH16 4TJ (United Kingdom); Medical Ultrasound Physics and Technology Group, School of Physics, Dublin Institute of Technology, Dublin 8 (Ireland)

    2011-02-15

    Purpose: A range of anatomically realistic multimodality renal artery phantoms consisting of vessels with varying degrees of stenosis was developed and evaluated using four imaging techniques currently used to detect renal artery stenosis (RAS). The spatial resolution required to visualize vascular geometry and the velocity detection performance required to adequately characterize blood flow in patients suffering from RAS are currently ill-defined, with the result that no one imaging modality has emerged as a gold standard technique for screening for this disease. Methods: The phantoms, which contained a range of stenosis values (0%, 30%, 50%, 70%, and 85%), were designed for use with ultrasound, magnetic resonance imaging, x-ray computed tomography, and x-ray digital subtraction angiography. The construction materials used were optimized with respect to their ultrasonic speed of sound and attenuation coefficient, MR relaxometry (T{sub 1},T{sub 2}) properties, and Hounsfield number/x-ray attenuation coefficient, with a design capable of tolerating high-pressure pulsatile flow. Fiducial targets, incorporated into the phantoms to allow for registration of images among modalities, were chosen to minimize geometric distortions. Results: High quality distortion-free images of the phantoms with good contrast between vessel lumen, fiducial markers, and background tissue to visualize all stenoses were obtained with each modality. Quantitative assessments of the grade of stenosis revealed significant discrepancies between modalities, with each underestimating the stenosis severity for the higher-stenosed phantoms (70% and 85%) by up to 14%, with the greatest discrepancy attributable to DSA. Conclusions: The design and construction of a range of anatomically realistic renal artery phantoms containing varying degrees of stenosis is described. Images obtained using the main four diagnostic techniques used to detect RAS were free from artifacts and exhibited adequate contrast

  1. HMGB1 is associated with atherosclerotic plaque composition and burden in patients with stable coronary artery disease.

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    Martin Andrassy

    Full Text Available OBJECTIVES: The role of inflammation in atherosclerosis is widely appreciated. High mobility group box 1 (HMGB1, an injury-associated molecular pattern molecule acting as a mediator of inflammation, has recently been implicated in the development of atherosclerosis. In this study, we sought to investigate the association of plasma HMGB1 with coronary plaque composition in patients with suspected or known coronary artery disease (CAD. DESIGN: HMGB1, high sensitive troponin T (hsTnT and high sensitive C-reactive protein (hsCRP were determined in 152 consecutive patients with suspected or known stable CAD who underwent clinically indicated 256-slice coronary computed tomography angiography (CCTA. Using CCTA, we assessed 1 coronary calcification, 2 non-calcified plaque burden and 3 the presence of vascular remodeling in areas of non-calcified plaques. RESULTS: Using univariate analysis, hsCRP, hsTnT and HMGB1 as well as age, and atherogenic risk factors were associated with non-calcified plaque burden (r = 0.21, p = 0.009; r = 0.48, p<0.001 and r = 0.34, p<0.001, respectively. By multivariate analysis, hsTnT and HMGB1 remained independent predictors of the non-calcified plaque burden (r = 0.48, p<0.01 and r = 0.34, p<0.001, respectively, whereas a non-significant trend was noticed for hs-CRP (r = 0.21, p = 0.07. By combining hsTnT and HMGB1, a high positive predictive value for the presence of non-calcified and remodeled plaque (96% and 77%, respectively was noted in patients within the upper tertiles for both biomarkers, which surpassed the positive predictive value of each marker separately. CONCLUSIONS: In addition to hs-TnT, a well-established cardiovascular risk marker, HMGB1 is independently associated with non-calcified plaque burden in patients with stable CAD, while the predictive value of hs-CRP is lower. Complementary value was observed for hs-TnT and HMGB1 for the prediction of complex coronary plaque.

  2. Assessment of Arterial Stiffness, Volume, and Nutritional Status in Stable Renal Transplant Recipients

    OpenAIRE

    Czyzewski, Lukasz; Wyzgal, Janusz; Czyzewska, Emilia; Kurowski, Andrzej; Sierdzinski, Janusz; Truszewski, Zenon; Szarpak, Lukasz

    2016-01-01

    Abstract Reduction of cardiovascular death might have a significant effect on the long-term survival rates of renal transplant recipients (RTRs). The aim of the study was to assess the relation between arterial stiffness and graft function, adipose tissue content, and hydration status in patients after kidney transplantation (KTx). The study included 83 RTR patients (mean age: 55 ± 13 years) who had been admitted to a nephrology-transplantation outpatient clinic 0.5 to 24 years after KTx. Cli...

  3. Renal and endocrine changes in rats with inherited stress-induced arterial hypertension (ISIAH)

    DEFF Research Database (Denmark)

    Amstislavsky, Sergej; Welker, Pia; Frühauf, Jan-Henning;

    2006-01-01

    Hypertensive inbred rats (ISIAH; inherited stress-induced arterial hypertension) present with baseline hypertension (>170 mmHg in adult rats), but attain substantially higher values upon mild emotional stress. We aimed to characterize key parameters related to hypertension in ISIAH. Kidneys......; epithelial Na channel-alpha; 11beta-hydroxysteroid dehydrogenase type 2) were increased. These data suggest enhanced volume conservation by the kidney. Our data define ISIAH as an attractive model for the renal components determining salt and water homeostasis in hypertension. The specific condition of a...

  4. Barium can replace calcium in calmodulin-dependent contractions of skinned renal arteries of the rabbit.

    Science.gov (United States)

    Kreye, V A; Hofmann, F; Mühleisen, M

    1986-03-01

    Renal arteries of the rabbit were chemically skinned using Triton X-100. In EGTA-buffered solutions containing calmodulin and ATP, small strips of the skinned preparations were found to develop contractile force which was dependent on the concentrations of either free calcium or of free barium. However, a 220 times greater concentration of barium than of calcium was necessary for comparable effects. Quantitatively, the response to barium was dependent on the concentration of calmodulin added to the test solutions. The contractile effect of barium was partly antagonized by the calmodulin antagonist, trifluoperazine. PMID:3960707

  5. Accuracy of colour duplex sonography for the diagnosis of renal artery stenosis

    DEFF Research Database (Denmark)

    Saeed, Aso; Bergström, Göran; Zachrisson, Karin;

    2009-01-01

    carried out at less than 4 months (mean 34 days) before renal angiography during a 6-year period (2002-2007). A significant RAS was defined as an at least 60% stenosis on angiography or a transstenotic mean arterial pressure gradient of at least 10 mmHg or both. RESULTS: In a total of 169 patients, 111.......01) in stenotic kidneys. CONCLUSION: ACCmax and AImax provide similar, good diagnostic accuracy in the detection of a haemodynamically significant RAS, even in patients with markedly reduced glomerular filtration rate. Presumably, the lack of superiority of the novel index AImax could be explained by a...

  6. Endovascular Management of Complex Renal Artery Aneurysms Using the Multilayer Stent

    International Nuclear Information System (INIS)

    Since its approval as an innovative stent system for peripheral aneurysm management in May 2009, the Cardiatis Multilayer Stent (Cardiatis, Isnes, Belgium) has been applied in several clinical cases. The unique design of this multilayer stent decreases mean velocity and vorticity within the aneurysm sac immediate and causes thrombus to form, resulting in physiological exclusion of the aneurysm from the circulation, whereas branches and collaterals sprouting from the aneurysm remain patent. Here we present a case of a complex renal artery aneurysm successfully treated with a 6 × 30-mm Cardiatis Multilayer Stent.

  7. Spontaneous Dissection of the Renal Artery in Vascular Ehlers-Danlos Syndrome

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    Filipa Pereira

    2015-01-01

    Full Text Available Ehlers-Danlos syndrome (EDS is a rare heterogeneous group of connective tissue disorders. The vascular type (vEDS is an autosomal dominant disorder caused by heterozygous mutations in the COL3A1 gene predisposing to premature arterial, intestinal, or uterine rupture. We report a case of a 38-year-old woman with a recent diagnosis of vEDS admitted in the Emergency Department with a suspicion of a pyelonephritis that evolved to a cardiopulmonary arrest. A fatal retroperitoneal hematoma related with a haemorrhagic dissection of the right renal artery was found after emergency surgery. This case highlights the need to be aware of the particular characteristics of vEDS, such as a severe vascular complication that can lead to a fatal outcome.

  8. CAROTID ATHEROSCLEROTIC LESION IN YOUNG PATIENTS

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    N. V. Pizova

    2014-01-01

    Full Text Available Objective: to determine the incidence of atherosclerotic lesions in the carotid and vertebral arteries of young patients from Doppler ultrasound data and to compare the quantitatively assessed traditional risk factors of coronary heart disease (CHD with severe extracranial artery atherosclerotic lesion.Subjects and methods. Doppler ultrasound was carried out evaluating structural changes in the aortic arch branches in 1563 railway transport workers less than 45 years of age. A separate sample consisted of 68 young people with carotid atherosclerotic changes, in whom traditional risk factors for CHD were studied, so were in a control group of individuals without atherosclerotic changes (n = 38.Results. Among the examinees, carotid atherosclerotic lesion was detected in 112 (7.1 % cases, the increase in the rate of atherosclerotic plaques in patients aged 35–45 years being 9.08 %; that in the rate of local intima-media thickness in those aged 31–40 years being 5.1 %. Smoking (particularly that along with hypercholesterolemia and a family history of cardiovascular diseases, obesity (along with low activity, and emotional overstrain were defined as important risk factors in the young patients. Moreover, factor analysis has shown that smoking,hypertension, and early cardiovascular pathology in the next of kin makes the greatest contribution to the development of carotid atherosclerotic lesion.Conclusion. Among the patients less than 45 years of age, carotid and vertebral artery atherosclerotic changes were found in 112 (7.1 % cases, which were more pronounced in male patients. Smoking, particularly along with hypercholesterolemia and genetic predisposition to cardiovascular diseases, was a risk factor that had the highest impact on the degree of atherosclerotic lesion in the aortic arch branches of the young patients.

  9. Renal Dysfunction after Off-Pump Coronary Artery Bypass Surgery- Risk Factors and Preventive Strategies

    Directory of Open Access Journals (Sweden)

    Gaurab Maitra

    2009-01-01

    Full Text Available Postoperative renal dysfunction is a relatively common and one of the serious complications of cardiac surgery. Though off-pump coronary artery bypass surgery technique avoids cardiopulmonary bypass circuit induced adverse effects on renal function, multiple other factors cause postoperative renal dysfunction in these groups of patients. Acute kidney injury is generally defined as an abrupt and sustained decrease in kidney function. There is no consen-sus on the amount of dysfunction that defines acute kidney injury, with more than 30 definitions in use in the literature today. Although serum creatinine is widely used as a marker for changes in glomerular filtration rate, the criteria used to define renal dysfunction and acute renal failure is highly variable. The variety of definitions used in clinical studies may be partly responsible for the large variations in the reported incidence. Indeed, the lack of a uniform definition for acute kidney injury is believed to be a major impediment to research in the field. To establish a uniform definition for acute kidney injury, the Acute Dialysis Quality Initiative formulated the Risk, Injury, Failure, Loss, and End-stage Kidney (RIFLE classification. RIFLE , defines three grades of increasing severity of acute kidney injury -risk (class R, injury (class I and failure (class F - and two outcome classes (loss and end-stage kidney disease. Various perioperative risk factors for postoperative renal dysfunction and failure have been identified. Among the important preoperative factors are advanced age, reduced left ventricular function, emergency surgery, preoperative use of intraaortic balloon pump, elevated preoperative serum glucose and creatinine. Most important intraoperative risk factor is the intraoperative haemodynamic instability and all the causes of postoperative low output syndrome com-prise the postoperative risk factors. The most important preventive strategies are the identification of the

  10. Successful technical and clinical outcome using a second generation balloon expandable coronary stent for transplant renal artery stenosis: Our experience

    Science.gov (United States)

    Salsamendi, Jason; Pereira, Keith; Baker, Reginald; Bhatia, Shivank S; Narayanan, Govindarajan

    2015-01-01

    Transplant renal artery stenosis (TRAS) is a vascular complication frequently seen because of increase in the number of renal transplantations. Early diagnosis and management is essential to optimize a proper graft function. Currently, the endovascular treatment of TRAS using angioplasty and/or stenting is considered the treatment of choice with the advantage that it does not preclude subsequent surgical correction. Treatment of TRAS with the use of stents, particularly in tortuous transplant renal anatomy presents a unique challenge to an interventional radiologist. In this study, we present three cases from our practice highlighting the use of a balloon-expandable Multi-Link RX Ultra coronary stent system (Abbott Laboratories, Abbott Park, Illinois, USA) for treating high grade focal stenosis along very tortuous renal arterial segments. Cobalt–Chromium alloy stent scaffold provides excellent radial force, whereas the flexible stent design conforms to the vessel course allowing for optimal stent alignment. PMID:26629289

  11. Different modulatory effects of ammonium ions on angiotensin vascular actions in isolated rat aortic and renal arteries

    Directory of Open Access Journals (Sweden)

    Popescu Raducu I.

    2012-01-01

    Full Text Available In the present study, we were interested in the vascular effects of angiotensin II on perfused rings of the rat thoracic aorta and renal artery. Our results demonstrated different modulator alterations of these preparations induced by ammonium ions. Unlike the aortic rings, which exhibited only a reduction of angiotensin-induced contractility by NH4Cl, the renal artery preparations showed both activation of vasoconstriction and inhibition of vasorelaxation in the ring precontracted with phenylephrine or noradrenalin. These results are interpreted as a modulation by the ammonium ions of vascular reactions induced by the stimulation of the vasoconstrictor AT1 receptor on the one side and AT2 vasodilator receptors on the other. The potentiation of renal vasoconstriction accompanied by the reduction of angiotensin vasodilation by NH4Cl suggests the possibility of involvement from the blood flow and renal vascular tonus disturbances induced by ammonium ions during hyperammonemia of various causes.

  12. Successful technical and clinical outcome using a second generation balloon expandable coronary stent for transplant renal artery stenosis: Our experience.

    Science.gov (United States)

    Salsamendi, Jason; Pereira, Keith; Baker, Reginald; Bhatia, Shivank S; Narayanan, Govindarajan

    2015-10-01

    Transplant renal artery stenosis (TRAS) is a vascular complication frequently seen because of increase in the number of renal transplantations. Early diagnosis and management is essential to optimize a proper graft function. Currently, the endovascular treatment of TRAS using angioplasty and/or stenting is considered the treatment of choice with the advantage that it does not preclude subsequent surgical correction. Treatment of TRAS with the use of stents, particularly in tortuous transplant renal anatomy presents a unique challenge to an interventional radiologist. In this study, we present three cases from our practice highlighting the use of a balloon-expandable Multi-Link RX Ultra coronary stent system (Abbott Laboratories, Abbott Park, Illinois, USA) for treating high grade focal stenosis along very tortuous renal arterial segments. Cobalt-Chromium alloy stent scaffold provides excellent radial force, whereas the flexible stent design conforms to the vessel course allowing for optimal stent alignment. PMID:26629289

  13. Losartan renography for the detection of renal artery stenosis: comparison with captopril renography and evaluation of dose and timing

    Energy Technology Data Exchange (ETDEWEB)

    Guenay, Emel Ceylan; Erguen, Eser Lay; Salanci, Bilge Volkan; Ugur, Oemer; Caner, Biray [Hacettepe University Faculty of Medicine, Department of Nuclear Medicine, Ankara (Turkey); Oeztuerk, M. Halil; Hekimoglu, Baki [Social Security Hospital Clinic of Radiology, Ankara (Turkey); Altun, Buelent [Hacettepe University Faculty of Medicine, Department of Nephrology, Ankara (Turkey); Cil, Barbaros [Hacettepe University Faculty of Medicine, Department of Radiology, Ankara (Turkey)

    2005-09-01

    Radionuclide renography with angiotensin converting enzyme (ACE) inhibition plays an important role in the diagnosis of haemodynamically significant renal artery stenosis. Angiotensin receptor antagonists inhibit the renin angiotensin system at different levels from ACE inhibitors by selectively blocking the binding of angiotensin II to AT1 receptors. The AT1 angiotensin receptor antagonist losartan has recently been used clinically in the treatment of hypertension. However, the available data on the use of losartan with renography for the detection of renovascular hypertension are limited and contradictory. The purpose of this prospective study was to compare the effectiveness of losartan renography and captopril scintigraphy in revealing renal artery stenosis. A total of 61 renal units in 32 patients with hypertension were studied in two groups based on the losartan dosage (50 mg in group A and 100 mg in group B). Group A consisted of 17 patients, in whom 19 renal units had angiographically proven renal artery stenosis ({>=}50%). In group B, there were 15 patients, in whom 20 renal arteries were stenotic. All of the patients underwent three renographies (baseline, captopril renography and early losartan renography). Early losartan renography was performed at 1 h after oral losartan administration in both groups. In group B, seven patients underwent additional losartan renography (late losartan) performed 3 h after oral losartan administration; these patients composed group B1. The sensitivities of captopril and losartan studies were 63.2% and 42% in group A, 65% and 65% in group B and 55.6% and 66.6% in group B1, respectively. From our preliminary results, we conclude that losartan is not superior to captopril renography for the detection of haemodynamically significant renal artery stenosis. However, a high dose (100 mg) of losartan provided higher sensitivity than the lower dose (50 mg). Late losartan scintigraphy provided similar diagnostic efficacy to early

  14. Renal effects of dexmedetomidine during coronary artery bypass surgery: a randomized placebo-controlled study

    Directory of Open Access Journals (Sweden)

    Scheinin Harry

    2011-05-01

    Full Text Available Abstract Background Dexmedetomidine, an alpha2-adrenoceptor agonist, has been evaluated as an adjunct to anesthesia and for the delivery of sedation and perioperative hemodynamic stability. It provokes dose-dependent and centrally-mediated sympatholysis. Coronary artery bypass grafting (CABG with extracorporeal circulation is a stressful procedure increasing sympathetic nervous system activity which could attenuate renal function due the interrelation of sympathetic nervous system, hemodynamics and renal function. We tested the hypothesis that dexmetomidine would improve kidney function in patients undergoing elective CABG during the first two postoperative days. Methods This was a double-blind, randomized, parallel-group study. Patients with normal renal function and scheduled for elective CABG were randomized to placebo or to infusion of dexmedetomidine to achieve a pseudo steady-state plasma concentration of 0.60 ng/ml. The infusion was started after anesthesia induction and continued until 4 h after surgery. The primary endpoint was creatinine clearance. Other variables included urinary creatinine and output, fractional sodium and potassium excretion, urinary potassium, sodium and glucose, serum and urinary osmolality and plasma catecholamine concentrations. The data were analyzed with repeated-measures ANOVA or Cochran-Mantel-Haenszel test. Results Sixty-six of 87 randomized patients were evaluable for analysis. No significant between-group differences were recorded for any indices of renal function except for a mean 74% increase in urinary output with dexmedetomidine in the first 4 h after insertion of a urinary catheter (p Conclusions Use of intravenous dexmedetomidine did not alter renal function in this cohort of relatively low-risk elective CABG patients but was associated with an increase in urinary output. This study was carried out in 1994-1997 and was thus not registered.

  15. Long term results of endovascular treatment in renal arterial stenosis from Takayasu arteritis: Angioplasty versus stent placement

    Energy Technology Data Exchange (ETDEWEB)

    Park, Hong Suk, E-mail: hongsukpark@gmail.com [Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Irwon-dong, Gangnam-gu, 135-710 Seoul (Korea, Republic of); Do, Young Soo, E-mail: ysdo@skku.edu [Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Irwon-dong, Gangnam-gu, 135-710 Seoul (Korea, Republic of); Park, Kwang Bo, E-mail: kbjh.park@samsung.com [Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Irwon-dong, Gangnam-gu, 135-710 Seoul (Korea, Republic of); Kim, Duk-Kyung, E-mail: dukkyung.kim@samsung.com [Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Irwon-dong, Gangnam-gu, 135-710 Seoul (Korea, Republic of); Choo, Sung Wook, E-mail: sw.choo@samsung.com [Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Irwon-dong, Gangnam-gu, 135-710 Seoul (Korea, Republic of); Shin, Sung Wook, E-mail: sw88.shin@samsung.com [Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Irwon-dong, Gangnam-gu, 135-710 Seoul (Korea, Republic of); Cho, Sung Ki, E-mail: sungkismc@samsung.com [Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Irwon-dong, Gangnam-gu, 135-710 Seoul (Korea, Republic of); Hyun, Dongho, E-mail: mesentery.hyun@samsung.com [Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Irwon-dong, Gangnam-gu, 135-710 Seoul (Korea, Republic of); Choo, In Wook, E-mail: inwook.choo@samsung.com [Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Irwon-dong, Gangnam-gu, 135-710 Seoul (Korea, Republic of)

    2013-11-01

    Purpose: To retrospectively evaluate and compare the long term patency and antihypertensive effect of angioplasty and stent insertion in renal artery stenosis caused by Takayasu arteritis, with CT angiography and clinical follow-up. Materials and methods: We retrospectively analyzed and compared effects on hypertension and patency of renal artery in 16 patients (age ranging from 16 to 58 years, mean: 32.1 years) with renovascular hypertension caused by Takayasu arteritis who underwent endovascular treatment including angioplasty (n = 13) and stent placement (n = 9) for 22 stenotic renal arteries. Results: Technical success was 95% (21/22) without major complications. In the last follow-up CT angiogram (mean 85 ± 41 months), restenosis was 8% (1/12) in angioplasty and 66% (6/9) in stent. Patency rates of angioplasty were 100%, 91.7%, 91.7% and primary unassisted and primary assisted patency rates of stent placement were 55.6%, 33.3%, 33.3% and 88.9%, 66.7%, 55.6% at 1-, 3- and 5-years, respectively. In clinical follow-up (mean 120 ± 37.8 months, range 48–183 months), beneficial effects on hypertension were obtained in 87% of patients (13/15) and there was no significant difference between the patients who were treated by only angioplasty and the patients who received stent placement in at least one renal artery, regardless of whether or not angioplasty had been performed in the other renal artery. Conclusion: Compared with stent placement, angioplasty demonstrated better long term patency and similar clinical benefit on renovascular hypertension in renal artery stenosis of Takayasu arteritis. We suggest that stent placement should be reserved for obvious angioplasty failure.

  16. Long term results of endovascular treatment in renal arterial stenosis from Takayasu arteritis: Angioplasty versus stent placement

    International Nuclear Information System (INIS)

    Purpose: To retrospectively evaluate and compare the long term patency and antihypertensive effect of angioplasty and stent insertion in renal artery stenosis caused by Takayasu arteritis, with CT angiography and clinical follow-up. Materials and methods: We retrospectively analyzed and compared effects on hypertension and patency of renal artery in 16 patients (age ranging from 16 to 58 years, mean: 32.1 years) with renovascular hypertension caused by Takayasu arteritis who underwent endovascular treatment including angioplasty (n = 13) and stent placement (n = 9) for 22 stenotic renal arteries. Results: Technical success was 95% (21/22) without major complications. In the last follow-up CT angiogram (mean 85 ± 41 months), restenosis was 8% (1/12) in angioplasty and 66% (6/9) in stent. Patency rates of angioplasty were 100%, 91.7%, 91.7% and primary unassisted and primary assisted patency rates of stent placement were 55.6%, 33.3%, 33.3% and 88.9%, 66.7%, 55.6% at 1-, 3- and 5-years, respectively. In clinical follow-up (mean 120 ± 37.8 months, range 48–183 months), beneficial effects on hypertension were obtained in 87% of patients (13/15) and there was no significant difference between the patients who were treated by only angioplasty and the patients who received stent placement in at least one renal artery, regardless of whether or not angioplasty had been performed in the other renal artery. Conclusion: Compared with stent placement, angioplasty demonstrated better long term patency and similar clinical benefit on renovascular hypertension in renal artery stenosis of Takayasu arteritis. We suggest that stent placement should be reserved for obvious angioplasty failure

  17. THE RELATIONSHIP OF THE CHRONIC RENAL FAILURE WITH CAROTID ARTERY CALCIFICATIONS, DENTAL PULP CALCIFICATIONS AND DENTAL PULP STONES

    OpenAIRE

    DAĞISTAN, Saadettin; MİLOĞLU, Özkan

    2015-01-01

    ABSTRACT Objective: The aim of this study was to investigate the existence of carotid artery calcifications in dental panoramic radiographs and dental pulp calcifications together with dental pulp stones in periapical radiographs in patients with chronic renal failure undergoing haemodialysis and healthy individuals, and to identify the relationship between the two groups.Patients and methods: A total of 115 cases (57 patients on haemodialysis for chronic renal failure and 58 healthy individu...

  18. Successful technical and clinical outcome using a second generation balloon expandable coronary stent for transplant renal artery stenosis: Our experience

    OpenAIRE

    Salsamendi, Jason; Pereira, Keith; Baker, Reginald; Bhatia, Shivank S; Narayanan, Govindarajan

    2015-01-01

    Transplant renal artery stenosis (TRAS) is a vascular complication frequently seen because of increase in the number of renal transplantations. Early diagnosis and management is essential to optimize a proper graft function. Currently, the endovascular treatment of TRAS using angioplasty and/or stenting is considered the treatment of choice with the advantage that it does not preclude subsequent surgical correction. Treatment of TRAS with the use of stents, particularly in tortuous transplant...

  19. Association between microalbuminuria and subclinical atherosclerosis evaluated by carotid artery intima-media in elderly patients with normal renal function

    OpenAIRE

    Kong XiangLei; Jia XiaoYan; Wei Yong; Cui MeiYu; Wang ZunSong; Tang LiJun; Li WenBin; Zhu ZhuXian; Chen Ping; Xu DongMei

    2012-01-01

    Abstract Background Moderate to severe renal insufficiency and albuminuria have been shown to be independent risk factors for atherosclerosis. However, little is known about the direct association between subclinical atherosclerosis evaluated by carotid artery intima-media thickness (IMT) and microalbuminuria in elderly patients with normal renal function. Methods Subjects were 272 elderly patients (age  ≥ 60 years) with normoalbuminuria (n = 238) and microalbuminuria (n = 34). Carotid IMT wa...

  20. Effect of naringin on hemodynamic changes and left ventricular function in renal artery occluded renovascular hypertension in rats

    OpenAIRE

    Asjad Visnagri; Mohammad Adil; Amit D Kandhare; Subhash L. Bodhankar

    2015-01-01

    Background: Renal artery occlusion (RAO) induced hypertension is a major health problem associated with structural and functional variations of the renal and cardiac vasculature. Naringin a flavanone glycoside derived possesses metal-chelating, antioxidant and free radical scavenging properties. Objective: The objective of this study was to investigate the antihypertensive activity of naringin in RAO induced hypertension in rats. Material and Methods: Male Wistar rats (180-200 g) were divided...

  1. Predictability of Vesicoureteral Reflux Using Interlobar Renal Arterial Resistive Indices in Sonographically Normal Pediatric Kidneys-Preliminary Results

    OpenAIRE

    John Amodio; Rafael Rivera; Lynne Pinkney; Naomi Strube; Nancy Fefferman

    2012-01-01

    Objective: To prospectively evaluate the diagnostic utility of interlobar renal arterial resistive index values, in predicting the presence of vesicoureteral reflux in children with sonographically normal appearing kidneys. Methods: We investigated 35 children with a history of urinary tract infection with grayscale and color Doppler ultrasound (US) fol-lowed by a standard voiding cystouretherogram to assess the presence of vesicoureteral reflux. All renal units (individ-ual kidneys) were mor...

  2. Spiral Computed Tomographic Angiography of the Renal Arteries: A Prospective Comparison with Intravenous and Intraarterial Digital Subtraction Angiography

    International Nuclear Information System (INIS)

    Purpose: To assess the accuracy of computed tomographic angiography (CTA) in the evaluation of the renal arteries in comparison with intravenous (IVDSA) and intraarterial digital subtraction angiography (IADSA). Methods: In 18 patients, 35 CTAs and DSAs (27 IADSA, 8 IVDSA) of the renal arteries were performed. CTA was done with 2-3 mm collimation, 2-4 mm/sec table speed, after intravenous injection of 80 ml of contrast medium at 4 ml/sec with a scanning delay time of 14-21 sec. No previous circulation time curve was performed. CTA data were reconstructed with maximum intensity projection (MIP) and shaded surface display (SSD). The presence of stenosis was assessed on a three-point rating scale (grade 1-3). The quality of the examinations; visualization of the ostium, the main artery, and its branches; vessel sharpness, linearity, and intraluminal contrast filling were evaluated. We compared CTA with DSA. Results: CTA had 96% sensitivity, 77% specificity, and 89% accuracy in the detection of stenoses > 50%. Due to technical errors two stenoses were erroneously diagnosed as positive but there were no false negative diagnoses. The quality of CTA was good in 56% and moderate in 34% of cases. Visualization of the ostium and main artery was graded as 1.74 (out of 2) points and of the renal branches as 1.02 (out of 2) points. The quality of CTA images was worse than that of IADSA in 52%, equal in 41%, and better in 7% of cases. CTA was equal to IVDSA in 25% and better in 75% of the cases. Conclusion: CTA is an accurate noninvasive method for the evaluation of renal arteries. Examination quality is essential for the diagnosis. CTA is limited in its ability to visualize the branches of the renal artery and accessory arteries. CTA seems to be superior to IVDSA

  3. Transcatheter arterial embolization as therapy of renal angiomyolipomas: The evolution in 15 years of experience

    International Nuclear Information System (INIS)

    Objective: This study aims at presenting the evolution of the embolization technique in treating renal angiomyolipomas (AMLs) either diagnosed in patients with acute bleeding or discovered accidentally. Methods: Ten patients with renal AMLs have been through thirteen selective transcatheter arterial embolizations for 15 years. Two patients had tuberous sclerosis complex (TSC) with bilateral tumors and were embolized twice. Four embolic materials were employed: PVA particles, Gianturco coils, microspheres and microcoils. Catheterization was achieved by means of 5F Cobra 2 catheters and coaxial microcatheter systems. Results: On an emergency basis, embolization was a first-line treatment. In one case, surgery was necessary; in two patients, a second embolization was performed. When treatment was preventive, a single embolization proved to be sufficient, as well. There was no significant deterioration of the serum creatinine levels in the post-embolization period. Conclusion: Selective arterial embolization is a rather safe and effective technique to treat AMLs both urgently and preventively. Different embolic materials can be employed. Microspheres and microcatheters stand for new promising materials

  4. Multidetector computed tomography angiography of the renal arteries: normal anatomy and its variations*

    Science.gov (United States)

    de Mello Júnior, Carlos Fernando; Araujo Neto, Severino Aires; de Carvalho Junior, Arlindo Monteiro; Rebouças, Rafael Batista; Negromonte, Gustavo Ramalho Pessoa; de Oliveira, Carollyne Dantas

    2016-01-01

    Conventional angiography is still considered the gold standard for the study of the anatomy and of vascular diseases of the abdomen. However, the advent of multidetector computed tomography and techniques of digital image reconstruction has provided an alternative means of performing angiography, without the risks inherent to invasive angiographic examinations. Therefore, within the field of radiology, there is an ever-increasing demand for deeper knowledge of the anatomy of the regional vasculature and its variations. Variations in the renal vascular system are relatively prevalent in the venous and arterial vessels. For various conditions in which surgical planning is crucial to the success of the procedure, knowledge of this topic is important. The aim of this study was to familiarize the general radiologist with variations in the renal vascular system. To that end, we prepared a pictorial essay comprising multidetector computed tomography images obtained in a series of cases. We show patterns representative of the most common anatomical variations in the arterial blood supply to the kidneys, calling attention to the nomenclature, as well as to the clinical and surgical implications of such variations.

  5. Transcatheter arterial embolization as therapy of renal angiomyolipomas: The evolution in 15 years of experience

    Energy Technology Data Exchange (ETDEWEB)

    Chatziioannou, A.; Gargas, D. [University of Athens, Aretaieion Hospital, Radiology Department (Greece); Malagari, K. [University of Athens, Imaging and Research Unit, Evgenidion Hospital (Greece); Kornezos, I., E-mail: kornezos@gmail.com [University of Athens, Aretaieion Hospital, Radiology Department (Greece); Ioannidis, I.; Primetis, E. [University of Athens, Aretaieion Hospital, Radiology Department (Greece); Moschouris, H. [University of Athens, Imaging and Research Unit, Evgenidion Hospital (Greece); Gouliamos, A.; Mourikis, D. [University of Athens, Aretaieion Hospital, Radiology Department (Greece)

    2012-09-15

    Objective: This study aims at presenting the evolution of the embolization technique in treating renal angiomyolipomas (AMLs) either diagnosed in patients with acute bleeding or discovered accidentally. Methods: Ten patients with renal AMLs have been through thirteen selective transcatheter arterial embolizations for 15 years. Two patients had tuberous sclerosis complex (TSC) with bilateral tumors and were embolized twice. Four embolic materials were employed: PVA particles, Gianturco coils, microspheres and microcoils. Catheterization was achieved by means of 5F Cobra 2 catheters and coaxial microcatheter systems. Results: On an emergency basis, embolization was a first-line treatment. In one case, surgery was necessary; in two patients, a second embolization was performed. When treatment was preventive, a single embolization proved to be sufficient, as well. There was no significant deterioration of the serum creatinine levels in the post-embolization period. Conclusion: Selective arterial embolization is a rather safe and effective technique to treat AMLs both urgently and preventively. Different embolic materials can be employed. Microspheres and microcatheters stand for new promising materials.

  6. ACE inhibition is superior to angiotensin receptor blockade for renography in renal artery stenosis

    Energy Technology Data Exchange (ETDEWEB)

    Karanikas, Georgios; Becherer, Alexander; Wiesner, Karoline; Dudczak, Robert; Kletter, Kurt [Department of Nuclear Medicine, University of Vienna (Austria)

    2002-03-01

    Angiotensin converting enzyme (ACE) inhibitors as well as angiotensin II receptor antagonists are able to prevent the vasoconstrictive effect of angiotensin II on the efferent renal vessels, which is believed to play an important role in renovascular hypertension. This effect is assumed to be essential for the demonstration of renovascular hypertension by captopril renography. In this study, renographic changes induced by captopril and the AT1 receptor antagonist valsartan were compared in patients with a high probability for renovascular hypertension. Twenty-five patients with 33 stenosed renal arteries (grade of stenosis >50%) and hypertension were studied. Captopril, valsartan and baseline renography were performed within 48 h using technetium-99m mercaptoacetyltriglycine. Blood pressure was monitored, plasma renin concentration before and after intervention was determined and urinary flow was estimated from the urinary output of the hydrated patients. Alterations in renographic curves after intervention were evaluated according to the Santa Fe consensus on ACE inhibitor renography. Captopril renography was positive, indicating renovascular hypertension, in 25 of the 33 stenosed vessels, whereas valsartan renography was positive in only ten. Blood pressure during captopril and valsartan renography was not different; reduction in blood pressure was the same after valsartan and captopril. Plasma renin concentration was comparable for valsartan and captopril studies, showing suppressed values after intervention in as many as 12 of the 25 patients. Urinary flow after valsartan was higher than after captopril (P<0.05). However, this difference could not explain the markedly higher sensitivity of captopril compared with valsartan in demonstrating renal artery stenosis. In 14 of the 25 patients, blood pressure response to revascularisation was monitored, showing a much better predictive value for captopril renography. It is concluded that captopril renography is much

  7. Nuclear medicine and coronary artery disease: evaluation of tracers of myocardial perfusion and vulnerable atherosclerotic plaque; Medecine nucleaire et maladie coronarienne: evaluation de traceurs de la perfusion myocardique et de la plaque d'atherome vulnerable

    Energy Technology Data Exchange (ETDEWEB)

    Broisat, A

    2005-04-15

    Coronary artery disease is one of the primary cause of mortality worldwide. Nuclear medicine is the major imaging technique for diagnosis and following of this disease. perfusion: nowadays, major radioactive agents used in clinical practice are myocardial perfusion tracers. The reference tracer is thallium-201. However, {sup 201}Tl presents some drawbacks. {sup 99m}Tcn-noet has been proposed for its replacement. This study shows that in contrast with previous studies realized in vitro on cardio myocytes, verapamil, an l-type calcium channel inhibitor, does not inhibit myocardial fixation of {sup 99m}Tcn-noet in vivo in dog. This data is in agreement with the hypothesis of a non specific endothelial fixation of this tracer. Moreover, this study shows that as a pure tracer of myocardial perfusion, {sup 99m}Tcn-noet can also be used to assess myocardial viability on a model of myocardial chronic infarction in rat. atherosclerosis: disruption of vulnerable atherosclerotic plaques is the main event leading to coronary accidents. The second part of this study concerns the evaluation of new potential tracers of the vulnerable atherosclerotic plaque in an experimental model of rabbit with an inheritable hypercholesterolemia. The four tracers evaluated (b2702(r), b2702-I, b2702-Tc and Tc-raft-b2702) are synthetic peptides comprising the residues 75-84 of hla-b2702, a molecule known to link vcam-1, an adhesion molecule expressed in vulnerable atherosclerotic plaque. The autoradiography studies show that all tracers accumulate within atherosclerotic plaque expressing vcam- and that. i-b2702 shows the best plaque/control fixation ratio. (author)

  8. Impaired Fasting Glucose and Diabetes as Predictors for Radial Artery Calcification in End Stage Renal Disease Patients

    OpenAIRE

    Katarzyna Janda; Marcin Krzanowski; Mariusz Gajda; Paulina Dumnicka; Danuta Fedak; Grzegorz J. Lis; Piotr Jaśkowski; Jan A. Litwin; Władysław Sułowicz

    2013-01-01

    Objective. The objective of the study was to assess the relationship between selected clinical and biochemical parameters of end stage renal disease (ESRD) patients and arterial calcification. Materials and Methods. The study comprised 59 stage 5 chronic kidney disease patients (36 hemodialyzed and 23 predialysis). The examined parameters included common carotid artery intima-media thickness (CCA-IMT), BMI, incidence of diabetes and impaired fasting glucose (IFG), dyslipidemia, hypertension, ...

  9. The Myth of “The Vulnerable Plaque”: Transitioning from a Focus on Individual Lesions to Atherosclerotic Disease Burden for Coronary Artery Disease Risk Assessment

    Science.gov (United States)

    Arbab-Zadeh, Armin; Fuster, Valentin

    2014-01-01

    The cardiovascular science community has pursued the quest to identify vulnerable atherosclerotic plaque in patients for decades, hoping to prevent acute coronary events. However, despite major advancements in imaging technology that allow visualization of rupture-prone plaques, clinical studies have not demonstrated improved risk prediction compared to traditional approaches. Considering the complex relationship between plaque rupture and acute coronary event risk suggested by pathology studies and confirmed by clinical investigations, these results are not surprising. This review summarizes the evidence supporting a multifaceted hypothesis of the natural history of atherosclerotic plaque rupture. Managing patients at risk of suffering acute coronary events mandates a greater focus on the atherosclerotic disease burden, rather than on features of individual plaques. PMID:25601032

  10. Non-enhanced ECG-gated respiratory-triggered 3-D steady-state free-precession MR angiography with slab-selective inversion: initial experience in visualisation of renal arteries in free-breathing children without renal artery abnormality

    International Nuclear Information System (INIS)

    ECG-gated non-enhanced balanced steady-state free precession (bSSFP) MR angiography requires neither breath-holding nor administration of contrast material. To investigate the image quality of free-breathing ECG-gated non-enhanced bSSFP MR angiography of renal arteries in children. Fourteen boys and seven girls (mean age, 9.7 years; range, 7 weeks-17 years) with no history of renovascular disease were included. MRI was performed at 1.5 T. Subjective image quality of axial and coronal maximum-intensity-projection reconstructions of four segments (I, aorta and renal artery ostium; II, main renal artery; III, segmental branches; IV, intrarenal vessels) was evaluated using a 4-point scale (4 = excellent, 3 = good, 2 = acceptable, 1 = non-diagnostic). Image quality was excellent for segments I (mean ± SD, 3.9 ± 0.3) and II (4.0 ± 0.1), good for segment III (3.4 ± 0.9) and acceptable for segment IV (2.3 ± 1.1). Mean image quality did not differ between sedated and non-sedated children. bSSFP MR angiography enables visualisation of renal arteries in children. (orig.)

  11. Disección espontánea de la arteria renal e infarto renal: Dos casos clínicos Spontaneous dissection of the renal artery ano kidney infarction: Report of two cases

    Directory of Open Access Journals (Sweden)

    Francisco Borja

    2008-09-01

    Full Text Available We report two previously healthy males aged 33 and 37 years, presenting with severe pain in the right and left part of the abdomen, respectively. An abdominal CT sean showed in both a kidney infarction. An angio-CAT sean showed changes compatible with a fibromuscular dysplasia in the renal arterial wall. An angiography showed an intimal tear or complex dissection flap in both cases. Both had a satisfactory evolution with conservative treatment. The relationship between fibromuscular dysplasia and spontaneous dissection of the renal artery is discussed.

  12. Evidence that blood pressure remains under the control of arterial baroreceptors in renal hypertensive rats

    Directory of Open Access Journals (Sweden)

    A.S. Trindade Jr.

    2009-10-01

    Full Text Available The purpose of the present study was to determine the range of the influence of the baroreflex on blood pressure in chronic renal hypertensive rats. Supramaximal electrical stimulation of the aortic depressor nerve and section of the baroreceptor nerves (sinoaortic denervation were used to obtain a global analysis of the baroreceptor-sympathetic reflex in normotensive control and in chronic (2 months 1-kidney, 1-clip hypertensive rats. The fall in blood pressure produced by electrical baroreceptor stimulation was greater in renal hypertensive rats than in normotensive controls (right nerve: -47 ± 8 vs -23 ± 4 mmHg; left nerve: -51 ± 7 vs -30 ± 4 mmHg; and both right and left nerves: -50 ± 8 vs -30 ± 4 mmHg; P < 0.05. Furthermore, the increase in blood pressure level produced by baroreceptor denervation in chronic renal hypertensive rats was similar to that observed in control animals 2-5 h (control: 163 ± 5 vs 121 ± 1 mmHg; 1K-1C: 203 ± 7 vs 170 ± 5 mmHg; P < 0.05 and 24 h (control: 149 ± 3 vs 121 ± 1 mmHg; 1K-1C: 198 ± 8 vs 170 ± 5 mmHg; P < 0.05 after sinoaortic denervation. Taken together, these data indicate that the central and peripheral components of the baroreflex are acting efficiently at higher arterial pressure in renal hypertensive rats when the aortic nerve is maximally stimulated or the activity is abolished.

  13. The diagnosis of bilateral renal artery thrombosis due to circular rupture of the intima following blunt abdominal trauma

    International Nuclear Information System (INIS)

    A case of bilateral renal artery thrombosis due to circular rupture of the intima following blunt abdominal trauma is reported. A further 15 published cases are tabulated. The pathogenetic mechanism, symptoms, course and value of various diagnostic techniques are discussed. The importance of early and specific radiological diagnosis is stressed and the value of angiography is pointed out. The literature is quoted extensively. (orig.)

  14. Evaluation of renal artery stenosis on CT-angiography: Comparison of various rendering techniques (AXIAL, MPR, MIP, SSD)

    International Nuclear Information System (INIS)

    Purpose: To evaluate the various reconstruction methods of helical-CT angiography for the assessment of hemodynamically relevant renal artery stenoses in comparison to i.a. DSA. Methods: In 76 renal arteries the reconstruction modalities AXIAL, MRP, MIP and SSD of helical-CT angiography were compared with the results of i.a. DSA for the determination of the grade and location of the stenosis. Results: The highest accuracy of stenosis grading was 76% with AXIAL reconstruction. In 8% of the cases grading of the stenosis was not evaluable by the AXIAL reconstruction. In these cases, a higher sensitivity in the detection of hemodynamically relevant stenoses (>grade II, >50%) was achieved with the reconstruction mode MPR (96%) than with MIP (92%). In 51% of the cases the reconstruction mode SSD was not suitable for any diagnosis of renal artery stenosis because of overlying calcified plaques. Conclusions: The evidence of hemodynamically relevant stenosis in helical-CT angiography in comparison to i.a. DSA succeeds most reliably by using the reconstruction modality AXIAL in combination with MRP. The MIP reconstruction provides information about the anatomy of the renal arteries within one image. (orig.)

  15. 20-HETE induces remodeling of renal resistance arteries independent of blood pressure elevation in hypertension.

    Science.gov (United States)

    Ding, Yan; Wu, Cheng-Chia; Garcia, Victor; Dimitrova, Irina; Weidenhammer, Adam; Joseph, Gregory; Zhang, Frank; Manthati, Vijay L; Falck, John R; Capdevila, Jorge H; Schwartzman, Michal L

    2013-09-01

    20-Hydroxyeicosatetraenoic acid (20-HETE) is a cytochrome P-450 (Cyp)-derived arachidonic acid metabolite that has been shown to increase smooth muscle contractions and proliferation, stimulate endothelial dysfunction and activation, and promote hypertension. We examined if 20-HETE contributes to microvascular remodeling in hypertension. In Sprague-Dawley rats, administration of the 20-HETE biosynthesis inhibitor HET0016 or the 20-HETE antagonist N-20-hydroxyeicosa-6(Z),15(Z)-dienoic acid (20-HEDE) prevented 5α-dihydrotestosterone (DHT)-induced increases in blood pressure as well as abrogated DHT-induced increases in the media-to-lumen ratio (M/L), media thickness, and collagen IV deposition in renal interlobar arteries. Reserpine prevented blood pressure elevation in DHT-treated rats but did not affect microvascular remodeling (M/L, media thickness, and collagen deposition); under these conditions, treatment with the 20-HETE antagonist attenuated microvascular remodeling, suggesting that 20-HETE contributes to DHT-induced vascular remodeling independent of blood pressure elevation. In Cyp4a14(-/-) mice, which display androgen-driven and 20-HETE-dependent hypertension, treatment with the 20-HETE antagonist abolished remodeling of renal resistance arteries measured as media thickness (24 ± 1 vs. 15 ± 1 μm) and M/L (0.29 ± 0.03 vs. 0.17 ± 0.01). Moreover, in Cyp4a12 transgenic mice in which the expression of Cyp4a12-20-HETE synthase is driven by a tetracycline-sensitive promoter, treatment with doxycycline resulted in blood pressure elevation (140 ± 4 vs. 92 ± 5 mmHg) and a significant increase in remodeling of renal resistance arteries (media thickness: 23 ± 1 vs. 16 ± 1 μm; M/L: 0.39 ± 0.04 vs. 0.23 ± 0.02); these increases were abrogated by cotreatment with 20-HEDE. This study demonstrated that 20-HETE is a key regulator of microvascular remodeling in hypertension; its effect is independent of blood pressure elevation and androgen levels. PMID

  16. Pleural effusion as a result of chronic renal ischemia.

    Science.gov (United States)

    Akopov, Andrey; Semenov, Dmitry; Karev, Andrey; Filippov, Denis; Lukina, Olga

    2011-09-01

    We would like to present a case of patient with a transudative pleural effusion as a result of atherosclerotic occlusion of renal arteries. About 50 liters of fluid were drained from the right pleural cavity during 10 months period of observation. Successful revascularization of kidneys improved left ventricular function, stabilized hemodynamic of the pulmonary circulation and thus led to elimination of pleural effusion. PMID:22263089

  17. Pleural effusion as a result of chronic renal ischemia

    Science.gov (United States)

    Akopov, Andrey; Semenov, Dmitry; Karev, Andrey; Filippov, Denis; Lukina, Olga

    2011-01-01

    We would like to present a case of patient with a transudative pleural effusion as a result of atherosclerotic occlusion of renal arteries. About 50 liters of fluid were drained from the right pleural cavity during 10 months period of observation. Successful revascularization of kidneys improved left ventricular function, stabilized hemodynamic of the pulmonary circulation and thus led to elimination of pleural effusion. PMID:22263089

  18. Association between renal dysfunction and the mixed plaque of coronary artery on computed tomographic angiography

    International Nuclear Information System (INIS)

    Coronary artery plaque is related to development of coronary artery disease (CAD), and chronic kidney disease is associated with CAD. However, the association of renal dysfunction (RD) with coronary artery plaque characteristics has not been fully elucidated. We evaluated the association between RD and coronary artery plaque characteristics in patients with suspected CAD, who underwent multislice computed tomographic angiography (CTA). A total of 918 patients were classified into 4 groups: group with no plaque (NP) (48.9%), group with calcified plaque (CP) (16.0%), group with noncalcified plaque (NCP) (22.4%), and group with mixed plaque (MP) (12.7%). NCP is considered as rupture-prone soft plaque, and CP as more stable lesion. The mean of estimated glomerular filtration rate (eGFR) was 82.5±15.4 mL/min/1.73 m2, and the prevalence of RD (defined as eGFR 2) was 6.3%. The prevalence of RD was 3.3% in the NP group, 10.2% in the CP group, 5.3% in the NCP group, and 14.5% in the MP group (P<0.001 by ANOVA tests). The adjusted odds ratio for RD was 3.38 (95% confidence interval, 1.27-9.04) for the MP group, compared with the NP group. The presence of RD showed an independent association with the MP counts (r=0.155, P<0.001); however, there was no association between RD and other plaque characteristics. In conclusion, RD is associated with MP rather than CP or NCP, compared with NP, which may reflect one of the developmental processes of CAD in patients with RD. (author)

  19. RENAL INVOLVEMENT IN SUBJECTS WITH PERIPHERAL ATHEROSCLEROSIS

    International Nuclear Information System (INIS)

    Ischemic nephropathy is an important cause of renal failure.Sub-clinical renal function abnormalities may exist in patients with extra renal atherosclerosis and may precede the onset of overt ischemic nephropathy. To assess the impact of extrarenal atherosclerosis on the kidney, the study evaluated renal function in 50 subjects with differing degrees of peripheral atherosclerosis without manifest clinical or laboratory signs of ischemic nephropathy and renovascular hypertension.All laboratory testing including total LDL and HDL-cholesterol, triglycerides, ultrasonography with Doppler analysis for the localization of peripheral vascular disease (carotid and lower limb arteries), and non-invasive evaluation of renal function by radionuclide studies of renal plasma flow (MAG3 clearance) and glomerular filtration (DTPA clearance) were determined as well as smoking habit was recorded. By combining sonographic data on arterial tree stenosis (ATS), the subjects were grouped according to the atherosclerotic vascular damage (ATS involvement). The results showed no change in plasma creatinine while DTPA clearance was increased from 91.58±26.53 to 93.47±24.82 ml/min/1.73 m. MAG3 clearance was progressively declined with the severity of vascular damage from 244.86 ± 60.60 to 173.59±58.74 ml/min/1.73 m.Stepwise, multiple regression analysis indicated that MAG3 clearance was best explained by ATS involvement (standardized B coefficient -0.40; P< 0.001), smoking habit (-0.34;P=0.004) and serum LDL-cholesterol (-0.24; P<0.035).It could be concluded that the renal hemodynamic profile in atherosclerotic patients might constitute functional evidence of the silent phase of ischemic renal disease. The findings suggest that renal function should be carefully assessed in patients with extrarenal atherosclerosis, particularly in those with classic cardiovascular risk factors

  20. Prevalence of renal artery stenosis in subjects with moderate hypertension. A population-based study

    DEFF Research Database (Denmark)

    Andersen, Ulrik B; Borglykke, Anders; Jørgensen, Torben

    2011-01-01

    Abstract Aim. To examine the prevalence of significant renal artery stenosis (RAS) in subjects with moderate to severe hypertension. Materials and methods. Subjects aged 50-66 years with blood pressure >160/100 mmHg or receiving antihypertensive treatment were selected from the population study...... balloon angioplasty. Two patients had reduced size and function of the affected kidney. Among the non-invasively treated patients, one showed stenosis progression at the 2-year follow-up examination. Conclusion. In subjects aged 50-66 years with hypertension grade II-III, RAS is rare among men, but not...... among women. These women may suffer from fibromuscular dysplasia. They are at risk of losing kidney function and developing severe hypertension, but they would not have been considered for screening according to present criteria....

  1. Emergency Pancreatoduodenectomy with Preservation of Gastroduodenal Artery for Massive Gastrointestinal Bleeding due to Duodenal Metastasis by Clear Cell Renal Cell Carcinoma in a Patient with Celiac Artery Stenosis

    Directory of Open Access Journals (Sweden)

    Kyriakos Neofytou

    2014-01-01

    Full Text Available Duodenal metastasis from renal cell carcinoma is rare, and even rarer is a massive gastrointestinal bleeding from such tumours. Coeliac occlusive disease, although rarely symptomatic, can lead to ischaemic changes with anastomotic dehiscence and leaks when a patient undergoes pancreatoduodenectomy. A 41-year-old man with known metastasis to the adrenal glands and the second part of the duodenum close to the ampulla of Vater from clear cell renal cell carcinoma was admitted to our department due to massive gastrointestinal bleeding from the duodenal metastasis. Endoscopic control of the bleed was not possible, while the bleeding vessel embolization was able to control the haemorrhage only temporarily. An angiography during the embolization demonstrated the presence of stenosis of the coeliac artery and also hypertrophic inferior pancreaticoduodenal arteries supplying the proper hepatic artery via the gastroduodenal artery (GDA. The patient underwent emergency pancreatoduodenectomy with preservation of the gastroduodenal artery. The patient had an uneventful recovery and did not experience further bleeding. Also the blood flow to the liver was compromised as shown by the normal liver function tests (LFTs postoperatively. To the best of our knowledge, this is the first report of a preservation of the GDA during an emergency pancreatoduodenectomy.

  2. Non-contrast-enhanced MRA of renal artery stenosis: validation against DSA in a porcine model

    International Nuclear Information System (INIS)

    To compare 3D-inversion-recovery balanced steady-state free precession (IR-bSSFP) non-contrast-enhanced magnetic resonance angiography (MRA) with 3D-contrast-enhanced MRA (CE-MRA) for assessment of renal artery stenosis (RAS) using digital subtraction angiography (DSA) as the reference standard. Bilateral RAS were surgically created in 12 swine. IR-bSSFP and CE-MRA were acquired at 1.5 T and compared to rotational DSA. Three experienced cardiovascular radiologists evaluated the IR-bSSFP and CE-MRA studies independently. Linear regression models were used to calibrate and assess the accuracy of IR-bSSFP and CE-MRA, separately, against DSA. The coefficient of determination and Cohen's kappa coefficient were also generated. Calibration of the three readers' RAS grading revealed R2 values of 0.52, 0.37 and 0.59 for NCE-MRA and 0.48, 0.53 and 0.71 for CE-MRA. Inter-rater agreement demonstrated Cohen's kappa values ranging from 0.25 to 0.65. Distal renal artery branch vessels were visible to a significantly higher degree with NCE-MRA compared to CE-MRA (p < 0.001). Image quality was rated excellent for both sequences, although image noise was higher with CE-MRA (p < 0.05). In no cases did noise interfere with image interpretation. In a well-controlled animal model of surgically induced RAS, IR-bSSFP based NCE-MRA and CE-MRA accurately graded RAS with a tendency for stenosis overestimation, compared to DSA. (orig.)

  3. Non-contrast-enhanced MRA of renal artery stenosis: validation against DSA in a porcine model

    Energy Technology Data Exchange (ETDEWEB)

    Bley, T.A. [University of Wuerzburg, Department of Diagnostic and Interventional Radiology, Wuerzburg (Germany); University of Wisconsin, Department of Radiology, Madison, WI (United States); Francois, C.J.; Schiebler, M.L. [University of Wisconsin, Department of Radiology, Madison, WI (United States); Wieben, O.; Del Rio, A.M.; Grist, T.M. [University of Wisconsin, Department of Radiology, Madison, WI (United States); University of Wisconsin, Department of Medical Physics, Madison, WI (United States); Takei, N. [GE Healthcare, MR Applied Sciences Laboratory, Tokyo (Japan); Brittain, J.H. [University of Wisconsin, Department of Radiology, Madison, WI (United States); GE Healthcare, MR Applied Sciences Laboratory, Madison, WI (United States); Reeder, S.B. [University of Wisconsin, Department of Radiology, Madison, WI (United States); University of Wisconsin, Department of Medical Physics, Madison, WI (United States); University of Wisconsin, Department of Biomedical Engineering, Madison, WI (United States); University of Wisconsin, Department of Medicine, Madison, WI (United States); University of Wisconsin, Department of Emergency Medicine, Madison, WI (United States)

    2016-02-15

    To compare 3D-inversion-recovery balanced steady-state free precession (IR-bSSFP) non-contrast-enhanced magnetic resonance angiography (MRA) with 3D-contrast-enhanced MRA (CE-MRA) for assessment of renal artery stenosis (RAS) using digital subtraction angiography (DSA) as the reference standard. Bilateral RAS were surgically created in 12 swine. IR-bSSFP and CE-MRA were acquired at 1.5 T and compared to rotational DSA. Three experienced cardiovascular radiologists evaluated the IR-bSSFP and CE-MRA studies independently. Linear regression models were used to calibrate and assess the accuracy of IR-bSSFP and CE-MRA, separately, against DSA. The coefficient of determination and Cohen's kappa coefficient were also generated. Calibration of the three readers' RAS grading revealed R{sup 2} values of 0.52, 0.37 and 0.59 for NCE-MRA and 0.48, 0.53 and 0.71 for CE-MRA. Inter-rater agreement demonstrated Cohen's kappa values ranging from 0.25 to 0.65. Distal renal artery branch vessels were visible to a significantly higher degree with NCE-MRA compared to CE-MRA (p < 0.001). Image quality was rated excellent for both sequences, although image noise was higher with CE-MRA (p < 0.05). In no cases did noise interfere with image interpretation. In a well-controlled animal model of surgically induced RAS, IR-bSSFP based NCE-MRA and CE-MRA accurately graded RAS with a tendency for stenosis overestimation, compared to DSA. (orig.)

  4. Comparison of Radiofrequency Ablation with Saturated Saline Preinjection and Renal Artery Occlusion: In Vivo Study in Canine Kidneys Preinjection and Renal Artery Occlusion: In Vivo Study in Canine Kidneys

    Energy Technology Data Exchange (ETDEWEB)

    Shin, Byung Seok; Ahn, Moon Sang [Chungnam National University Hospital, Daejeon (Korea, Republic of); Park, Mi Hyun [Dept. of Radiology, Dankook University Hospital, Cheonan (Korea, Republic of); Jeon, Gyeong Sik [Dept. of Radiology, CHA Bundang Medical Center, CHA University College of Medicine, Seongnam (Korea, Republic of); Lee, Byung Mo [Dept. of Surgery, Paik Hospital, Inje University College of Medicine, Seoul (Korea, Republic of); Lee, Ki Chang [Dept. of Veterinary Radiology, Chonbuk National University College of VeterinaryMedicine, Seoul (Korea, Republic of); Kim, Ho Jun [Dept. of Radiology, Konyang University Hospital, Daejeon (Korea, Republic of); Ohm, Joon Young [Dept. of Radiology, Bucheon St. Mary Hospital, The Catholic University of Korea College of Medicine, Bucheon (Korea, Republic of)

    2012-04-15

    To compare the ablation zone after radiofrequency ablation (RFA) with saturated saline preinjection and renal artery occlusion in canine kidneys. RFA was induced in the kidneys of six mongrel dogs. A total of 24 ablation zones were induced using a 1-cm tip internally cooled needle electrode in three groups: RFA (Control group), RFA with 0.5 mL saturated saline preinjection (SS group), and RFA with renal artery occlusion by atraumatic vascular clamp (Occlusion group). Ablation zone diameters were measured along transverse and longitudinal sections of the needle axis, and volumes were calculated. Temperature, applied voltage, current, and impedance during RFA were recorded automatically. The RFA zone volume was the largest in the SS group (1.33 {+-} 0.34 cm{sup 3}), followed by the Occlusion group (1.07 {+-} 0.38 cm{sup 3}) and then the Control group (0.62 {+-} 0.09 cm{sup 3}). Volumes for the SS and Occlusion groups were significantly larger than those for the Control group (p = 0.001, p = 0.012). There was no significant difference in volumes between the SS and Occlusion groups (p = 0.178). Saturated saline preinjection is as effective as renal arterial occlusion for expanding the ablation zone. RFA with saturated saline preinjection could help to treat large renal tumors.

  5. Leptin and the Regulation of Renal Sodium Handling and Renal Na-Transporting ATPases: Role in the Pathogenesis of Arterial Hypertension.

    Science.gov (United States)

    Bełtowski, Jerzy

    2010-02-01

    Leptin, an adipose tissue hormone which regulates food intake, is also involved in the pathogenesis of arterial hypertension. Plasma leptin concentration is increased in obese individuals. Chronic leptin administration or transgenic overexpression increases blood pressure in experimental animals, and some studies indicate that plasma leptin is elevated in hypertensive subjects independently of body weight. Leptin has a dose- and time-dependent effect on urinary sodium excretion. High doses of leptin increase Na(+) excretion in the short run; partially by decreasing renal Na(+),K(+)-ATPase (sodium pump) activity. This effect is mediated by phosphatidylinositol 3-kinase (PI3K) and is impaired in animals with dietary-induced obesity. In contrast to acute, chronic elevation of plasma leptin to the level observed in patients with the metabolic syndrome impairs renal Na(+) excretion, which is associated with the increase in renal Na(+),K(+)-ATPase activity. This effect results from oxidative stress-induced deficiency of nitric oxide and/or transactivation of epidermal growth factor receptor and subsequent stimulation of extracellular signal-regulated kinases. Ameliorating "renal leptin resistance" or reducing leptin level and/or leptin signaling in states of chronic hyperleptinemia may be a novel strategy for the treatment of arterial hypertension associated with the metabolic syndrome. PMID:21286276

  6. How Do Antihypertensive Drugs Work? Insights from Studies of the Renal Regulation of Arterial Blood Pressure.

    Science.gov (United States)

    Digne-Malcolm, Holly; Frise, Matthew C; Dorrington, Keith L

    2016-01-01

    Though antihypertensive drugs have been in use for many decades, the mechanisms by which they act chronically to reduce blood pressure remain unclear. Over long periods, mean arterial blood pressure must match the perfusion pressure necessary for the kidney to achieve its role in eliminating the daily intake of salt and water. It follows that the kidney is the most likely target for the action of most effective antihypertensive agents used chronically in clinical practice today. Here we review the long-term renal actions of antihypertensive agents in human studies and find three different mechanisms of action for the drugs investigated. (i) Selective vasodilatation of the renal afferent arteriole (prazosin, indoramin, clonidine, moxonidine, α-methyldopa, some Ca(++)-channel blockers, angiotensin-receptor blockers, atenolol, metoprolol, bisoprolol, labetolol, hydrochlorothiazide, and furosemide). (ii) Inhibition of tubular solute reabsorption (propranolol, nadolol, oxprenolol, and indapamide). (iii) A combination of these first two mechanisms (amlodipine, nifedipine and ACE-inhibitors). These findings provide insights into the actions of antihypertensive drugs, and challenge misconceptions about the mechanisms underlying the therapeutic efficacy of many of the agents. PMID:27524972

  7. Renal artery stenosis detection by combined Gates' technique and captopril test in hypertensive patients

    International Nuclear Information System (INIS)

    We studied 11 hypertensive patients by a radionuclide technique using Gates' method with [/sup 99m/Tc]DTPA to investigate the acute effects of captopril on glomerular filtration rate (GFR). Five patients had hypertension with unilateral renal artery stenosis (RAS) angiographically documented and six patients had essential hypertension (EH). Total and split GFR were determined under control conditions and after oral administration of captopril (50 mg). In the patients with RAS, captopril induced a significant decrease of GFR in the stenotic kidneys (from 42.4 +/- 4 to 29.6 +/- 3 ml/min, p less than 0.01), while no changes were observed in the nonstenotic kidneys (from 61.2 +/- 3 to 61.6 +/- 5 ml/min, NS). Total GFR was 103.6 +/- 5 ml/min under control conditions and decreased to 91.8 +/- 6 ml/min after captopril (p less than 0.05). No significant changes of GFR were detected after captopril administration in patients with EH. In a separate group of ten patients with EH, good correlation between 24-hr creatinine clearance and fractional uptake of [/sup 99m/Tc]DTPA was obtained. Good reproducibility of this radionuclide technique was also shown. This study demonstrates that the computed radionuclide GFR determination coupled with the captopril test allows one to unmask angiotensin II-dependent renal function and hemodynamic changes. This technique can be useful in clinical practice for identifying patients with renovascular hypertension

  8. Iodixanol in cardioangiography in patients with coronary artery disease; Tolerability, cardiac and renal effects

    Energy Technology Data Exchange (ETDEWEB)

    Klow, N.E.; Levorstad, K.; Berg, K.J.; Brodahl, U.; Endresen, K.; Kristoffersen, D.T.; Laake, B.; Simonsen, S.; Tofte, A.J.; Lundby, B. (Depts. of Radiology, Nephrology and Cardiology, National Hospital, Oslo (Norway) Nycomed AS, Oslo (Norway))

    1993-01-01

    Iodixanol is a new nonionic, dimeric contrast medium. With the addition of 18 mmol/l Na[sup +] and 0.3 mmol/l Ca[sup ++] to iodixanol 320 mg l/ml a plasma-isotonic solution was obtained. The purpose was to evaluate the suitability of iodixanol for use in cardioangiography by determining the diagnostic efficacy, patient tolerability, and cardiac and renal side-effects. Initially, 14 patients with coronary artery disease were examined using iodixanol. A double-blind, randomized study was then performed in 72 patients, comparing iodixanol and iohexol. Serum and urine were sampled before the examination, and one and 2 days after. The diagnostic information was good and the number of adverse events low with iodixanol. The patients reported significantly less of a sensation of warmth following injection of iodixanol than iohexol. Our results also indicate that iodixanol 320 mg/l ml influences renal function to a lesser degree than does iohexol 350 mg l/ml. We therefore conclude that isoteonic iodixanol is a safe contrast medium for use in cardioangiography. (orig.).

  9. USO DE LA ECOGRAFÍA RENAL EN EL ESTUDIO DE LA HIPERTENSIÓN ARTERIAL.

    Directory of Open Access Journals (Sweden)

    Gerardo Torres Torres MD

    2004-01-01

    Full Text Available Sonography has become accessible, easy to make and non-aggressive investigation which has been used commonly in clinical practice. Main aim of this study was to evaluate a clinical value of renal ultrasound in patients presenting arterial hypertension, the study was designed as a transversal, and retrospective on selected hypertensive patients. A clinical diagnostic of 236 patients with hypertension was review, 205 of them fulfilled diagnostic criteria of essential hypertension and 31 patients had secondary hypertension, with a mean age of 57,2 ± 14 years, being 117 (49.6% women and 119 (50.4% men. One of selecting criteria was a performed sonography test. In total, 121 patients divided in two groups (93 patients with essential hypertension and other of 28 with secondary hypertension were eligible for this study. The main variables had the same distribution to the baseline population. Renal sonography in secondary hypertension showed a sensitivity of 67,8% (CI 95:51-84% (Pathologic sonography Secondary hypertensión and the specificity of normal sonography into the essential hypertension was 85% (IC 95: 77-92%. (Normal sonography Essential hypertension the predictive value of a pathologic ecography for secondary hypertension was 57,6% (IC 95: 40-73% and the predictive value of a normal ecography for essential hypertension was 89,7% (IC 95: 83-96% (Essential hypertension Normal sonography In conclusion, renal ultrasound test does not seems to be a useful test in the management of hypertensive patients and even to ruled out a secondary hypertension because its low predictive value and also has a poor clinical value for essential hypertension because in most of the cases show unremarkable finding or does not report abnormalities (85%. RESUMEN: La ecografía se ha convertido en una prueba accesible, fácil de realizar y poco agresiva, lo que ha generalizado su uso en la práctica clínica. Con el objetivo de valorar si la ecografía renal aporta

  10. Astaxanthin vs placebo on arterial stiffness, oxidative stress and inflammation in renal transplant patients (Xanthin: a randomised controlled trial

    Directory of Open Access Journals (Sweden)

    Robertson Iain K

    2008-12-01

    Full Text Available Abstract Background There is evidence that renal transplant recipients have accelerated atherosclerosis manifest by increased cardiovascular morbidity and mortality. The high incidence of atherosclerosis is, in part, related to increased arterial stiffness, vascular dysfunction, elevated oxidative stress and inflammation associated with immunosuppressive therapy. The dietary supplement astaxanthin has shown promise as an antioxidant and anti-inflammatory therapeutic agent in cardiovascular disease. The aim of this trial is to investigate the effects of astaxanthin supplementation on arterial stiffness, oxidative stress and inflammation in renal transplant patients. Method and Design This is a randomised, placebo controlled clinical trial. A total of 66 renal transplant recipients will be enrolled and allocated to receive either 12 mg/day of astaxanthin or an identical placebo for one-year. Patients will be stratified into four groups according to the type of immunosuppressant therapy they receive: 1 cyclosporine, 2 sirolimus, 3 tacrolimus or 4 prednisolone+/-azathioprine, mycophenolate mofetil or mycophenolate sodium. Primary outcome measures will be changes in 1 arterial stiffness measured by aortic pulse wave velocity (PWV, 2 oxidative stress assessed by plasma isoprostanes and 3 inflammation by plasma pentraxin 3. Secondary outcomes will include changes in vascular function assessed using the brachial artery reactivity (BAR technique, carotid artery intimal medial thickness (CIMT, augmentation index (AIx, left ventricular afterload and additional measures of oxidative stress and inflammation. Patients will undergo these measures at baseline, six and 12 months. Discussion The results of this study will help determine the efficacy of astaxanthin on vascular structure, oxidative stress and inflammation in renal transplant patients. This may lead to a larger intervention trial assessing cardiovascular morbidity and mortality. Trial Registration

  11. Peripheral arterial vasodilation hypothesis: a proposal for the initiation of renal sodium and water retention in cirrhosis

    DEFF Research Database (Denmark)

    Schrier, R W; Arroyo, V; Bernardi, M;

    1988-01-01

    . While the occurrence of primary renal sodium and water retention and plasma volume expansion prior to ascites formation favors the "overflow" hypothesis, the stimulation of the renin-angiotensin-aldosterone system, vasopressin release and sympathetic nervous system associated with cirrhosis is not...... consonant with primary volume expansion. In this present article, the "Peripheral Arterial Vasodilation Hypothesis" is proposed as the initiator of sodium and water retention in cirrhosis. Peripheral arterial vasodilation is one of the earliest observations in the cirrhotic patient and experimental animals...... fistula and drug-induced peripheral arterial vasodilation. However, a predilection for the retained sodium and water to transudate into the abdominal cavity occurs with cirrhosis because of the presence of portal hypertension. The Peripheral Arterial Vasodilation Hypothesis also explains the continuum...

  12. Assessment of Arterial Stiffness, Volume, and Nutritional Status in Stable Renal Transplant Recipients.

    Science.gov (United States)

    Czyzewski, Lukasz; Wyzgal, Janusz; Czyzewska, Emilia; Kurowski, Andrzej; Sierdzinski, Janusz; Truszewski, Zenon; Szarpak, Lukasz

    2016-02-01

    Reduction of cardiovascular death might have a significant effect on the long-term survival rates of renal transplant recipients (RTRs). The aim of the study was to assess the relation between arterial stiffness and graft function, adipose tissue content, and hydration status in patients after kidney transplantation (KTx).The study included 83 RTR patients (mean age: 55 ± 13 years) who had been admitted to a nephrology-transplantation outpatient clinic 0.5 to 24 years after KTx. Clinical and laboratory data were analyzed and eGFR was calculated with the CKD-EPI formula. Arterial stiffness was assessed in all RTRs with pulse wave propagation velocity (PWV) with the use of a complior device. In addition, fluid and nutritional status was assessed with a Tanita BC 418 body composition analyzer. The control group consisted of 31 hospital workers who received no medication and had no history of cardiovascular disease.Multivariable linear regression analysis, with PWV as a dependent variable, retained the following independent predictors in the final regression model: red blood cell distribution width (RDW) (B = 0.323; P = 0.004), age (B = 0.297; P = 0.005), tacrolimus therapy (B = -0.286; P = 0.004), and central DBP (B = 0.185; P = 0.041). Multivariable linear regression analysis with eGFR as a dependent variable retained the following independent predictors in the final regression model; creatinine concentration (B = -0.632; P = 0.000), hemoglobin (B = 0.280; P = 0.000), CRP (B = -0.172; P = 0.011), tacrolimus therapy (B = 0.142; P = 0.039), and triglycerides (B = -0.142; P = 0.035).Our data indicates that: kidney transplant recipients can present modifiable CVD risk factors linked to increased arterial stiffness, DBP, waist circumference, SCr, time on dialysis, CyA therapy, and visceral fat mass; RDW is a parameter associated with arterial stiffness; and parameters such as CyA therapy, time on

  13. Evaluation of Visibility of Celiac and Renal Arteries on Digital Subtraction Angiography Using Iodine, Gadolinium and Carbon dioxide Contrast Agents: A Porcine Experimental Study

    OpenAIRE

    SHINMURA, Kohei; Baba, Yasutaka; HAYASHI, SADAO; Ikeda, Shunichiro; MOTOMURA, Eriko; KIYAO, Yutaro; NAKAJO, Masayuki; 新村, 耕平; 馬場, 康貴; 林, 完勇; 池田, 俊一郎; 本村, 江利子; 木屋尾, 祐太郎; 中條, 政敬

    2014-01-01

    Purpose: To examine the differences in visibility of celiac, renal arteries and nephrogram on digital subtraction angiography (DSA)among 3 different contrast agents in a porcine model.Methods: Six swine underwent percutaneous catheterization and DSA. Celiac and bilateral renal DSA angiograms with iodine,gadolinium and CO2 were obtained by the same injection protocols for each swine. The arterial diameter, contrast enhancement andrenal density were measured using the Image-J software. Assessme...

  14. Color Doppler Indices of Orbital Arterial Flow in End-Stage Renal Disease Patients; Are the Changes Related to Chronic Hemodialysis or Chronic Renal Failure?

    Directory of Open Access Journals (Sweden)

    Hadi Rokni Yazdi

    2012-03-01

    Full Text Available Background: Endothelial injury is a well-known complication in chronic kidney disease (CKD and hemodialysis. One of the sites in which early vascular changes may be detected is the retina. Of course, these flow changes may not be detected in ophthalmologic exams, but it seems that color Doppler sonography of retinal arteries may be helpful in these cases.Objectives: In previous studies on CKD patients who underwent chronic hemodialysis, hemodynamic changes were noted in retinal arteries, but no study has been performed to determine which of the two processes (CKD or chronic hemodialysis can produce these changes. In this study, we tried to answer this question.Patients and Methods: Doppler ultrasonography of the orbital vasculature including the ophthalmic artery and the central retinal artery was carried out in 17 patients (34 eyes with chronic renal failure (CRF who underwent hemodialysis, 17 patients (34 eyes with CRF without a history of hemodialysis and 17 normal patients (34 eyes. The peak systolic velocity (PSV, end diastolic velocity (EDV and resistance index were measured excluding hypertensive, diabetic patients and patients with cardiovascular disease.Results: The mean PSV and EDV were lower only in the ophthalmic artery of CRF patients irrespective of the history of hemodialysis (PSV was 35.2 in hemodialysis, 38.8 in CRF and 51.6 in normal patients, P value = 0.001 and EDV was 7.4, 9.4, 11.8, respectively, P value = 0.001 with no significant difference in the resistance index of the ophthalmic artery and other parameters [EDV, PSV, Resistance Index (RI] in the central retinal artery.Conclusions: The mean PSV and DSV in the ophthalmic artery were lower only in the ophthalmic artery of CRF patients regardless of the history of hemodialysis. No significant difference in the resistance index of the ophthalmic artery and other parameters (EDV, PSV of the central retinal artery were noted between different groups.These findings suggest

  15. Color Doppler Indices of Orbital Arterial Flow in End-Stage Renal Disease Patients; Are the Changes Related to Chronic Hemodialysis or Chronic Renal Failure?

    International Nuclear Information System (INIS)

    Endothelial injury is a well-known complication in chronic kidney disease (CKD) and hemodialysis. One of the sites in which early vascular changes may be detected is the retina. Of course, these flow changes may not be detected in ophthalmologic exams, but it seems that color Doppler sonography of retinal arteries may be helpful in these cases. In previous studies on CKD patients who underwent chronic hemodialysis,hemodynamic changes were noted in retinal arteries, but no study has been performed to determine which of the two processes (CKD or chronic hemodialysis) can produce these changes. In this study, we tried to answer this question. Doppler ultrasonography of the orbital vasculature including the ophthalmic artery and the central retinal artery was carried out in 17 patients (34 eyes) with chronic renal failure (CRF) who underwent hemodialysis, 17 patients (34 eyes)with CRF without a history of hemodialysis and 17 normal patients (34 eyes). The peak systolic velocity (PSV), end diastolic velocity (EDV) and resistance index were measured excluding hypertensive, diabetic patients and patients with cardiovascular disease. The mean PSV and EDV were lower only in the ophthalmic artery of CRF patients irrespective of the history of hemodialysis (PSV was 35.2 in hemodialysis, 38.8 in CRF and 51.6 in normal patients, P value = 0.001 and EDV was 7.4, 9.4, 11.8, respectively, P value =0.001) with no significant difference in the resistance index of the ophthalmic artery and other parameters [EDV, PSV, Resistance Index (RI)] in the central retinal artery. The mean PSV and DSV in the ophthalmic artery were lower only in the ophthalmic artery of CRF patients regardless of the history of hemodialysis. No significant difference in the resistance index of the ophthalmic artery and other parameters (EDV, PSV) of the central retinal artery were noted between different groups. These findings suggest that microvascular disease and endothelial cell dysfunction of the orbital

  16. Clinical & radiological evaluation of atherosclerotic changes in carotid & coronary arteries in asymptomatic & clinically symptomatic individuals as a tool for pre-symptomatic diagnosis of cardiovascular disease

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    Venkatraman Bhat

    2016-01-01

    Interpretation & conclusions: Age-related progression of atherosclerosis was evident in internal carotid arteries. Significant association was observed in the IMT thickness of right common carotid (RCC and coronary disease in symptomatic group; whereas IMT of left common carotid and internal carotid arteries did not show any association. RCC IMT between 0.5-0.7mm showed maximal association with significant symptomatic narrowing of coronary arteries. Patients with IMT beyond 0.7mm had no association with symptoms.

  17. El control de la presión arterial en la consulta de enfermedad renal crónica avanzada

    Directory of Open Access Journals (Sweden)

    Francisco Cirera Segura

    2014-03-01

    Full Text Available Nos propusimos valorar los resultados obtenidos, tras la formación e intervenciones de enfermería realizadas para mejorar la presión arterial, en pacientes con enfermedad renal crónica avanzada. Material y Método: Se realizó un estudio descriptivo retrospectivo, de 6 meses de duración. Se estudiaron todos los pacientes incidentes en la consulta de enfermedad renal crónica avanzada. Se recogieron los datos relacionados con la enfermedad renal crónica avanzada y su evolución, en la consulta inicial, a los tres y seis meses. Resultados: La muestra la formaron un total de 148 pacientes, de los cuales el 60,8% eran hombres. La edad media fue 68,7 ± 14,8 años. Evaluamos los cambios en las constantes vitales relacionadas con la presión arterial a lo largo del estudio, obteniendo diferencias significativas para la presión arterial sistólica (p<0,001, la presión arterial diastólica (p<0,001 y para la presión arterial media (p<0,001, no siendo así para la frecuencia cardiaca (p=0,307. El número de hipotensores disminuyó a lo largo del estudio sin significación estadística. Existió una diferencia significativa en el peso de los pacientes pasando de 80,1±16,7 kg. a 77,6±16,1 kg. al final del seguimiento (p<0,001. La presencia de edemas varió de un 26,1% a un 18,8% al concluir el estudio (p=0,052. Analizamos el sodio en orina (p=0,665 y observamos que no hubo diferencias significativas. Sí encontramos cambios significativos en el hábito tabáquico (p=0,004 pero no en el consumo de alcohol (p=0,5. Conclusiones: Las actividades de enfermería han conseguido mejorar el control de la presión arterial, a los pacientes incidentes en la consulta enfermedad renal crónica avanzada. Estas intervenciones deben ser una constante en el tratamiento del paciente hipertenso con enfermedad renal crónica avanzada.

  18. Renal Artery Stump to Inferior Vena Cava Fistula: Unusual Clinical Presentation and Transcatheter Embolization with the Amplatzer Vascular Plug

    International Nuclear Information System (INIS)

    Fistulous communication between the renal artery stump and inferior vena cava following nephrectomy is rare. We describe the case of a 52-year-old man with a fistula detected on investigation for hemolytic anemia in the postoperative period. The patient had had a nephrectomy performed 2 weeks prior to presentation for blunt abdominal trauma. The fistula was successfully occluded percutaneously using an Amplatzer vascular plug. The patient recovered completely and was discharged 2 weeks later.

  19. Trombólise tardia e espontânea de artéria renal sem comprometimento funcional Late and spontaneous thrombolysis of renal artery without functional impairtment

    Directory of Open Access Journals (Sweden)

    Claudio Pinho

    2009-09-01

    Full Text Available A aterosclerose em artérias renais é um importante fator desencadeante de tromboses com subsequente comprometimento da função e da viabilidade renal. A oclusão aguda das artérias renais por trombo ou êmbolo é causa incomum e potencialmente reversível de falência renal. Todavia, a duração e o grau de oclusão arterial compatível com a manutenção da viabilidade do parênquima renal ainda não estão bem estabelecidos, razão pela qual o diagnóstico precoce e a intervenção são importantes. O objetivo deste artigo é descrever um caso de trombose de artéria renal de rim funcional único, com lise espontânea e tardia do trombo seguida de recuperação funcional inesperada.Renal artery atherosclerosis is an important triggering factor for thrombosis followed by impairment of renal function and viability. The acute occlusion of the renal artery by a thrombus or an embolus is an unusual and potentially reversible cause of renal failure. However, the duration and degree of arterial occlusion compatible with the viability of the renal parenchyma have not been well established, hence the importance of early diagnosis and intervention. The purpose of this study is to describe a case of renal artery thrombosis of a functionally single kidney, with late and spontaneous thrombolysis followed by unexpected functional recovery.

  20. Ventricular repolarization before and after treatment in patients with secondary hypertension due to renal-artery stenosis and primary aldosteronism.

    Science.gov (United States)

    Maule, Simona; Bertello, Chiara; Rabbia, Franco; Milan, Alberto; Mulatero, Paolo; Milazzo, Valeria; Papotti, Grazia; Veglio, Franco

    2011-10-01

    A prolonged QT interval is a risk factor for ischemic heart disease in hypertensive subjects. Patients with renal-artery stenosis and primary aldosteronism (PA) are at increased risk of cardiovascular events. The objective of the present study was to evaluate the QT interval in patients with renovascular hypertension (RV) and PA before and after treatment. A total of 24 patients with RV and 38 with PA were studied; 89 patients with essential hypertension (EH) served as control group. Corrected QT intervals (QTcH) were measured from a 12-lead ECG. Basal QTcH was longer in RV (429±30 ms) and PA (423±23 ms) compared with EH controls (407±18 ms; P440 ms was higher in RV (29%) and PA patients (29%) compared with EH controls (4%; P<0.001). QTcH interval was evaluated after treatment in 19 RV and 15 PA patients. QTcH was reduced after renal-artery angioplasty in RV patients (419±14 ms; P=0.02), and after spironolactone or adrenalectomy in PA (403±12 ms; P=0.01). In conclusion, QT interval was prolonged in patients with RV and PA compared with controls with EH. After angioplasty of renal-artery stenosis in RV, and treatment with spironolactone or adrenalectomy in PA, the cardiovascular risk of such patients may be reduced by concomitant blood pressure lowering and QT duration shortening. PMID:21677661

  1. Utility of carotid intimal medial thickness as a screening tool for evaluation of coronary artery disease in pre-transplant end stage renal disease

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    Modi N

    2006-01-01

    Full Text Available Background : Coronary artery disease (CAD is associated with a higher incidence of allograft failure and mortalityin patients with end-stage renal disease (ESRD following renal transplant. Aim : To evaluate the efficacy of using carotid intimal medial thickness (CIMT to predict the presence of CADin patients with ESRD, using coronary angiography (CAG as the gold standard. Materials and Methods : This prospective study enrolled consecutive patients with ESRD who underwent CAGas a part of pretransplant evaluation to rule out the presence of atherosclerotic CAD. An operator who wasblinded with respect to the results of the CAG, measured carotid IMT in all patients prior to CAG and recordedit on videotape. Two independent observers blinded to the results of CAG measured carotid IMT offline tovalidate its predictive accuracy as a noninvasive test in predicting the presence or absence of CAD. Measurementof carotid IMT was done on USG B mode 7.5 MHZ probe [HP 5500 andover, Massachusetts]. Student′s t-testwas used for inter-group comparisons. Pearson correlation coefficient test was used to assess the relationbetween CAD and various risk factors and carotid IMT. Linear regression analysis was applied to identifyindependent factors determining presence of CAD. A P value < 0.05 was considered statistically significant. Results : Mean CIMT was significantly higher in those with CAD as compared to those without [0.80± 0.06 vs.0.70±0.06 mm, P< 0.0001. Patients with CIMT> 0.75 mm were older and had more incidence of diabetes(78% vs. 47%; P=0.001. Only 4/53 (7% of patients with CIMT< 0.75 mm had CAD, vs. 38/52 (73% in thosewith CIMT> 0.75 mm. The sensitivity and specificity of using CIMT > 0.75 as a predictor of CAD was 90.47%and 73% and its positive and negative predictive values were 0.73 and 0.92. On multivariate analysis, onlyCIMT was a significant predictor of CAD. Conclusion : Carotid IMT can be used to predict CAD in patients with ESRD. In the

  2. An unusual case of hematuria in a young female: renal artery embolism, mitral stenosis, and sinus rhythm.

    Science.gov (United States)

    Kumar, Ashok; Kapoor, Aditya; Kumar, Sudeep

    2016-03-01

    Renal artery embolism (RAE) is an uncommon entity that is most often secondary to a cardiac source. Most reported cases have been in patients with underlying atrial fibrillation (AF), and occurrence of RAE, especially in patients with valvular heart disease, and sinus rhythm is very rare. We describe an unusual case of a young female who presented with sudden onset right flank pain, vomiting, anorexia, and hematuria, and was found to have thrombotic occlusion of the distal right renal artery. Although she denied any previous cardiac history, detailed cardiovascular examination revealed the presence of severe rheumatic mitral stenosis without any evidence of AF or left atrial clot. She was initially managed conservatively using low molecular weight heparin followed by oral anticoagulation with resolution of symptoms. A successful balloon mitral valvotomy was performed six weeks later. The patient is asymptomatic at her last follow-up of six months with preserved renal function. In symptomatic patients, clinicians need to consider the possibility of RAE even in patients of valvular heart disease with underlying sinus rhythm. Appropriate management of the underlying cardiac condition is imperative since embolism may be recurrent leading to compromise of renal function, if left untreated. PMID:26997399

  3. Factors influencing the renal arterial Doppler waveform: a simulation study using an electrical circuit model (secondary publication

    Directory of Open Access Journals (Sweden)

    Chang Kyu Sung

    2016-01-01

    Full Text Available Purpose: The goal of this study was to evaluate the effect of vascular compliance, resistance, and pulse rate on the resistive index (RI by using an electrical circuit model to simulate renal blood flow. Methods: In order to analyze the renal arterial Doppler waveform, we modeled the renal blood-flow circuit with an equivalent simple electrical circuit containing resistance, inductance, and capacitance. The relationships among the impedance, resistance, and compliance of the circuit were derived from well-known equations, including Kirchhoff’s current law for alternating current circuits. Simulated velocity-time profiles for pulsatile flow were generated using Mathematica (Wolfram Research and the influence of resistance, compliance, and pulse rate on waveforms and the RI was evaluated. Results: Resistance and compliance were found to alter the waveforms independently. The impedance of the circuit increased with increasing proximal compliance, proximal resistance, and distal resistance. The impedance decreased with increasing distal compliance. The RI of the circuit decreased with increasing proximal compliance and resistance. The RI increased with increasing distal compliance and resistance. No positive correlation between impedance and the RI was found. Pulse rate was found to be an extrinsic factor that also influenced the RI. Conclusion: This simulation study using an electrical circuit model led to a better understanding of the renal arterial Doppler waveform and the RI, which may be useful for interpreting Doppler findings in various clinical settings.

  4. Young Women with a Long Past of Resistant Hypertension Cured after Surgery of Severe Bilateral Ostial Renal Artery Stenosis.

    Science.gov (United States)

    Simonnet, Blandine; Deharo, Pierre; Rouabah, Karim; Silhol, François; Soler, Raphael; Bartoli, Jean Michel; Lévrier, Olivier; Bartoli, Michel Alain; Magnan, Pierre Edouard; Sarlon-Bartoli, Gabrielle

    2016-07-01

    Fibromuscular dysplasia (FMD) is an underdiagnosed disease which can affect young people and with poor prognosis such as dissection or aneurysm rupture if unknown. This case illustrates a multi-vessel FMD with symptomatic severe bilateral ostial renal artery stenosis and intracranial aneurysms. One of the original features is a very late delay to diagnosis with 23 years between onset of hypertension and renal stenosis diagnosis, particularly due to lower quality of initial CT scan with milder and uncommon abnormalities. The experiment neuroradiologist had suspected the diagnosis of renal FMD because she developed intracranial aneurysms and he confirmed this diagnosis with an artery renal contrast injection during an intracranial angiogram Because of very tight and short stenosis, surgery was chosen for treatment and permitted the cure of hypertension, with normal home blood pressure after 6 months. Several particularities of FMD were presented in this case: important delay diagnosis due to rare lesion and lower sensitivity of CT in this form, the possibility to perform an angiography in high suspicion of FMD, poor prognosis risk with intracranial aneurisms and premature birth child, and the choice for surgery with cure of hypertension. We thought that hypertension etiologic evaluation must be repeated in case of resistant hypertension in young patients, particularly when they developed intracranial aneurysms. PMID:27174348

  5. Factors influencing the renal arterial Doppler waveform: a simulation study using an electrical circuit model (secondary publication)

    Energy Technology Data Exchange (ETDEWEB)

    Sung, Chang Kyu [Dept. of Radiology, SMG-SNU Boramae Medical Center, Seoul National University College of Medicine, Seoul (Korea, Republic of); Han, Bong Soo [Dept. of Radiological Science, College of Health Science, Yonsei University, Wonju (Korea, Republic of); Kim, Seung Hyup [Dept. of Radiology, Institute of Radiation Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul (Korea, Republic of)

    2016-01-15

    The goal of this study was to evaluate the effect of vascular compliance, resistance, and pulse rate on the resistive index (RI) by using an electrical circuit model to simulate renal blood flow. In order to analyze the renal arterial Doppler waveform, we modeled the renal blood-flow circuit with an equivalent simple electrical circuit containing resistance, inductance, and capacitance. The relationships among the impedance, resistance, and compliance of the circuit were derived from well-known equations, including Kirchhoff’s current law for alternating current circuits. Simulated velocity-time profiles for pulsatile flow were generated using Mathematica (Wolfram Research) and the influence of resistance, compliance, and pulse rate on waveforms and the RI was evaluated. Resistance and compliance were found to alter the waveforms independently. The impedance of the circuit increased with increasing proximal compliance, proximal resistance, and distal resistance. The impedance decreased with increasing distal compliance. The RI of the circuit decreased with increasing proximal compliance and resistance. The RI increased with increasing distal compliance and resistance. No positive correlation between impedance and the RI was found. Pulse rate was found to be an extrinsic factor that also influenced the RI. This simulation study using an electrical circuit model led to a better understanding of the renal arterial Doppler waveform and the RI, which may be useful for interpreting Doppler findings in various clinical settings.

  6. The stability of the atherosclerotic plaque depends on the extent of injured endothelium: results from a novel model of ischemia /reperfusion induced atherosclerosis in carotid artery of rats

    Institute of Scientific and Technical Information of China (English)

    晋学庆

    2014-01-01

    Objective To observe the atherogenic lesion progress in a novel ischemia/reperfusion induced atherosclerosis model in the carotid artery of rats.Methods Rats were divided into normal control,sham-operated control and ischemia-reperfusion injury(IRI)groups(n=10each).IRI was induced by 30 min carotid artery occlusion with a 2 cm

  7. Utility of color doppler ultrasound in the evaluation of renal artery stenosis in comparison with contrast-enhanced magnetic resonance angiography

    Directory of Open Access Journals (Sweden)

    Elnasri M Abuagla

    2014-01-01

    Full Text Available Renal artery stenosis (RAS is one of the main correctable causes of secondary systemic arterial hypertension. Color Doppler ultrasound (DUS, a non-invasive imaging modality, has been used to diagnose RAS in hypertensive patients. This study was conducted in the period between June 2008 and March 2010 to compare the sensitivity, specificity, accuracy and predictive values of DUS using contrast-enhanced magnetic resonance angiography (CEMRA as the gold standard for the diagnosis of RAS. Fifty-seven consecutive patients with clinical findings suggestive of RAS (32 males and 25 females with a mean age of 56 years (±7.92 years were referred to the University Kebangsaan Medical Center to be screened for RAS using DUS and CEMRA. RAS was considered significant if the reduction in diameter was >60%. A total of 114 arteries were assessed, 65 in males (57% and 49 in females (43%. On DUS, the parameters measured were the peak systolic velocity at the proximal main renal artery (PSV-P, distal main renal artery (PSV-D and the suprarenal aorta (PSV-A at the level of the renal hila and the acceleration time (AT at the main renal artery. The renal-renal ratio (RRR, which is the value of PSV-P/PSV-D, and the renal-aortic ratio (RAR, which is the value of PSV-P/PSV-A, were then calculated. The accuracy, sensitivity, specificity and positive and negative predictive values of DUS in the detection of significant RAS were determined. All measured DUS parameters were positive for the detection of RAS, with an accuracy of 98.3%. On retrospective review, all the arteries that showed significant stenosis on CEMRA demonstrated an irregular outline on DUS. We conclude that DUS is accurate in the diagnosis of significant RAS but is not very sensitive as a screening tool.

  8. Cyclotron production and parameters calculation of 48V Nitinol stent for renal arteries in brachytherapy

    International Nuclear Information System (INIS)

    The Nitinol stent was bombarded in a cyclotron at a flux rate of 4 μA/cm2 to produce 48V via 48Ti (p, n) 48V reaction. In this study dose distribution of 48V radioactive stent was investigated for renal arteries. Version X-2.6 of the MCNP Monte Carlo radiation transport system code was employed to calculate dose distribution around the stent. As 48V is a mixed gamma and beta particle emitter, two separate runs of MCNP for both beta and gamma particles were performed and the total deposited dose was acquired by adding the two mentioned values. In order to verify the simulation, the calculated results have been compared with previous published data for the source. Calculated results show high dose gradient near the stent and the maximum amount of dose deposits at the vessel wall. According to (AAPM) TG-60/149 protocol, the dosimetric parameters, including geometry function, G(ρ,z), radial dose function, g L (ρ), and anisotropy function, F(ρ,z), were also determined. (author)

  9. Effects of Restoration of Blood Flow on the Development of Aortic Atherosclerosis in ApoE−/− Mice With Unilateral Renal Artery Stenosis

    OpenAIRE

    Pathak, Alokkumar S.; Huang, Jianhua; Rojas, Mauricio; Bazemore, Taylor C.; Zhou, Ruihai; Stouffer, George A.

    2016-01-01

    Background Chronic unilateral renal artery stenosis (RAS) causes accelerated atherosclerosis in apolipoprotein E–deficient (ApoE−/−) mice, but effects of restoration of renal blood flow on aortic atherosclerosis are unknown. Methods and Results Male ApoE−/− mice underwent sham surgery (n=16) or had partial ligation of the right renal artery (n=41) with the ligature being removed 4 days later (D4LR; n=6), 8 days later (D8LR; n=11), or left in place for 90 days (chronic RAS; n=24). Ligature rem...

  10. Diagnóstico y tratamiento de la enfermedad carotídea aterosclerótica extracraneal asintomática Diagnosis and treatment of asymptomatic extracranial atherosclerotic carotid artery disease

    Directory of Open Access Journals (Sweden)

    Luciano A. Sposato

    2011-12-01

    Full Text Available La enfermedad aterosclerótica asintomática de la arteria carótida interna extracraneal alcanza una prevalencia de hasta el 12.5%. La angioplastia carotídea todavía no ha demostrado ser lo suficientemente segura y eficaz para prevenir el ACV isquémico en estos pacientes. Estudios aleatorizados demostraron que la endarterectomía carotídea es superior al tratamiento médico en cuanto a reducción del riesgo de ACV isquémico si es realizada por equipos con tasas de complicaciones (ACV o muerte menores que 3%. Sin embargo, los pacientes evaluados en estos estudios comenzaron a reclutarse hace más de 25 años, cuando la utilización de antiagregantes plaquetarios era menor que la actual, el tratamiento de la hipertensión arterial era menos efectivo y todavía no se usaban estatinas como componentes fundamentales de los esquemas de prevención vascular. La optimización de la calidad del tratamiento médico en las últimas décadas ha llevado a una significativa reducción del riesgo de ACV en pacientes no intervenidos quirúrgicamente. En base a estas observaciones y con la excepción de casos específicos, el tratamiento médico es la opción terapéutica de elección en pacientes con enfermedad aterosclerótica carotídea extracraneal asintomática.The reported prevalence of asymptomatic atherosclerotic disease of the extracranial internal carotid artery is up to 12.5%. Carotid angioplasty has not yet proven safe and effective enough to prevent ischemic stroke in these patients. Randomized studies showed that carotid endarterectomy is superior to medical therapy in reducing the risk of ischemic stroke when performed by surgical teams with complication rates (stroke or death of less than 3%. However, recruitment of these patients began more than 25 years ago, when the use of antiplatelet agents was lower than today, the treatment of hypertension was less effective than currently, and statins were not considered as key components of

  11. Embolization of renal arteries before transplantation in patients with polycystic kidney disease: a single institution long-term experience

    Energy Technology Data Exchange (ETDEWEB)

    Petitpierre, F.; Cornelis, F.; Lasserre, A.S.; Tricaud, E.; Le Bras, Y.; Grenier, N. [Pellegrin Hospital, Department of Radiology, Bordeaux (France); Couzi, L.; Merville, P. [Pellegrin Hospital, Department of Nephrology, Bordeaux (France); Combe, C.; Ferriere, J.M. [Pellegrin Hospital, Department of Urology, Bordeaux (France)

    2015-11-15

    We aimed to retrospectively assess the long-term safety and efficacy of embolization of renal arteries (ERA) in patients with polycystic kidney disease (PKD) before renal transplantation. Between January 2008 and November 2013, 82 ERA procedures were performed on 76 kidneys in 73 patients (mean age 53 years, range: 34-72). All patients had terminal-stage PKD and were under dialysis and on the renal transplant waiting list with a temporary contraindication due to excessive renal volume. ERA was considered successful in 89.5 % (68/76) of embolized kidneys, meaning that the temporary contraindication for transplantation could be withdrawn for 65 patients (on average 5.6 months, range: 2.8-24.3, after ERA). Mean volume reduction was 40 (range: 2-69) at 3 months and 59 % (35-86) thereafter (both p < 0.001). Post-embolization syndrome occurred after 15 of 82 procedures (18.3 %). The severe complication rate was 4.9 %. Forty-three (67.7 %) transplantations were successfully conducted after ERA, with a mean follow-up of 26.2 months (range: 1.8-59.5), and the estimated 5-year graft survival rate was 95.3 % [95 % CI: 82.7-98.8]. ERA is a safe and effective alternative to nephrectomy before renal transplantation in patients with PKD. (orig.)

  12. Economic impact of an ultrasonographic contrast agent on the diagnosis and initial management of patients with suspected renal artery stenosis

    International Nuclear Information System (INIS)

    To determine resource use in the diagnosis and management of Canadian hypertensive patients with suspected renal artery stenosis and to estimate the impact of diagnosis with contrast-enhanced duplex Doppler ultrasonography (US) on resource use. Seventy-eight patients with suspected renal artery stenosis underwent usual diagnostic tests (captopril-enhanced renal scintigraphy or duplex Doppler US) and contrast-enhanced US. A management pathway ('planned') describing the medical resources required for further patient care was outlined on the basis of results from each test (separately), and a modified management pathway ('recommended'), which considered data from both diagnostic methods, was also outlined. Medical resources and productivity losses were assessed prospectively for a 3-month period after patients underwent both tests ('actual' management pathway). With usual diagnostic methods, 14 (18%) of the tests were inconclusive, whereas only 1 (1%) of the enhanced US examinations was inconclusive; the cost-efficacy ratio was $422 and $343 per successful diagnosis, respectively. Further management costs for patients with an inconclusive diagnosis were estimated at $6370 after the usual diagnostic tests, but only $1278 with enhanced US. Although the costs of the planned and recommended management pathways were similar ($227 and $294 per patient respectively), the proportion of patients requiring further resources was lower with enhanced US (56% v. 46%). Three-month actual management costs ranged from $121 to $1605 per patient (mean $360). Diagnostic tests and surgical procedures were the major cost drivers in all pathways, and costs wore highest for patients in whom stenosis was diagnosed. For patients with suspected renal artery stenosis, contrast-enhanced US had a higher diagnostic success rate than usual diagnostic methods and afforded savings through lower administrative costs and lower medical resource consumption for patients whose diagnosis was unclear after

  13. Comparison of the relation between renal impairment, angiographic coronary artery disease, and long-term mortality in women versus men.

    Science.gov (United States)

    Chen, Ruoling; Kumar, Sanjeev; Timmis, Adam; Feder, Gene; Yaqoob, Muhammed M; Hemingway, Harry

    2006-03-01

    Mild to moderate renal impairment has recently been associated with increased cardiovascular mortality. However, gender differences in the association of mild to moderate renal impairment with the presence of angiographic coronary artery disease and long-term mortality remain unknown. We examined a prospective cohort of consecutive patients who underwent coronary angiography from the ACRE study in the Royal Hospitals Trust (London, United Kingdom) with referral from 5 contiguous health authorities. Among 1,609 patients (465 women) who had angiographic and serum creatinine measurements at baseline, renal impairment at modification of diet in renal disease glomerular filtration rates of 45 to 59, 30 to 44, and level of glomerular filtration rate, multivariate adjusted hazard ratios of 7-year all-cause mortality for women compared with men were higher: 2.64 (95% confidence intervals [CI] 1.21 to 5.73) versus 1.34 (95% CI 0.995 to 1.79); 2.62 (95% CI 1.12 to 16.12) versus 2.35 (95% CI 1.60 to 3.43); and 10.42 (95% CI 3.97 to 27.39) versus 4.77 (95% CI 2.95 to 7.70), respectively. Similar patterns were observed in cardiovascular and coronary deaths. In conclusion, mild to moderate renal impairment may be a marker for unmeasured proatherogenic factors for women only, and women may bear a greater mortality burden that is attributable to renal impairment compared with men. Gender may influence the prognostic effect of renal impairment in coronary disease. PMID:16490426

  14. Endovascular revascularization for aortoiliac atherosclerotic disease

    Science.gov (United States)

    Aggarwal, Vikas; Waldo, Stephen W; Armstrong, Ehrin J

    2016-01-01

    Atherosclerotic iliac artery disease is increasingly being treated with endovascular techniques. A number of new stent technologies can be utilized with high long-term patency, including self-expanding stents, balloon-expandable stents, and covered stents, but comparative data on these stent types and in more complex lesions are lacking. This article provides a review of currently available iliac stent technologies, as well as complex procedural aspects of iliac artery interventions, including approaches to the treatment of iliac bifurcation disease, long segment occlusions, choice of stent type, and treatment of iliac artery in-stent restenosis. PMID:27099509

  15. Cajaninstilbene acid relaxes rat renal arteries: roles of Ca2+ antagonism and protein kinase C-dependent mechanism.

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    Dong-Mei Zhang

    Full Text Available Cajaninstilbene acid (CSA is a major active component present in the leaves of Cajanus cajan (L. Millsp. The present study explores the underlying cellular mechanisms for CSA-induced relaxation in rat renal arteries. Vascular reactivity was examined in arterial rings that were suspended in a Multi Myograph System and the expression of signaling proteins was assessed by Western blotting method. CSA (0.1-10 µM produced relaxations in rings pre-contracted by phenylephrine, serotonin, 9, 11-dideoxy-9α, 11α-epoxymethanoprostaglandin F(2α (U46619, and 60 mM KCl. CSA-induced relaxations did not show difference between genders and were unaffected by endothelium denudation, nor by treatment with N(G-nitro-L-arginine methyl ester, indomethacin, ICI-182780, tetraethylammonium ion, BaCl(2, glibenclamide, 4-aminopyridine or propranolol. CSA reduced contraction induced by CaCl(2 (0.01-5 mM in Ca(2+-free 60 mM KCl solution and by 30 nM (--Bay K8644 in 15 mM KCl solution. CSA inhibited 60 mM KCl-induced Ca(2+ influx in smooth muscle of renal arteries. In addition, CSA inhibited contraction evoked by phorbol 12-myristate 13-acetate (PMA, protein kinase C agonist in Ca(2+-free Krebs solution. Moreover, CSA reduced the U46619- and PMA-induced phosphorylation of myosin light chain (MLC at Ser19 and myosin phosphatase target subunit 1 (MYPT1 at Thr853 which was associated with vasoconstriction. CSA also lowered the phosphorylation of protein kinase C (PKCδ at Thr505. In summary, the present results suggest that CSA relaxes renal arteries in vitro via multiple cellular mechanisms involving partial inhibition of calcium entry via nifedipine-sensitive calcium channels, protein kinase C and Rho kinase.

  16. The effectiveness of arterial embolization in renal angiomyolipoma. 14th kyushu cooperative urological research

    International Nuclear Information System (INIS)

    Arterial embolization has been used for the treatment of renal angiomyolipoma (AML). However, long-term data of a large number of patients treated with embolization are not available. In this study we evaluate the effectiveness of embolization in AML. From January 1998 to December 2002, 267 patients (290 kidneys) with AML were seen at 61 institutes throughout Kyushu, Japan, and were retrospectively analyzed. AML was diagnosed by histology or computed tomography (CT) combined with magnetic resonance imaging or ultrasonography. The percentage of post-embolization tumor size reduction was calculated by using the following formula: [(initial maximal tumor diameter - follow-up maximal tumor diameter) / initial maximal tumor diameter] x 100 (%). The mean age of 26 patients (31 kidneys) treated with embolization was 41.9 years (range, 20 to 71 yrs); 77% of the patients were female. Twenty-seven percent of the patients had a diagnosis of tuberous sclerosis. Presenting symptoms and signs for these 26 patients were incidental discovery in 11 (42.3%) and acute hemorrhage in 7 (26.9%). Arterial embolization was performed selectively in 28 kidneys and totally in 3 kidneys. Acute hemorrhage was controlled in 6 out of the 7 patients. Prophylactic embolization was performed in 11 asymptomatic patients with tumor size >3 cm and/or multiple tumors. Follow-up CT was performed for 25 embolization tumors. The average maximal tumor diameter just prior to embolization was 4.9±2.9 cm, becoming 2.9±2.7 cm following embolization. The maximal tumor diameter was reduced in 21 (84%) of the 25 embolization tumors, but did not change in the other 4 (16%). The average percentage of post-embolization tumor size reduction was 45.2±30.5% (mean follow-up duration, 28.1 months). There was a significant correlation between the percentage of tumor size reduction and the follow-up duration (R2=0.232, P=0.013). One patient underwent nephrectomy after embolization due to abscess formation, but the

  17. Kinks of the Transplant Renal Artery Without Accompanying Intraarterial Pressure Gradient Do Not Require Correction: Five-Year Outcome Study

    International Nuclear Information System (INIS)

    Significant transplant renal artery stenosis (TRAS) results in an intraarterial pressure gradient and increasing graft dysfunction correctable by endovascular therapy. Kinks of the transplant artery cause velocity gradients on Doppler ultrasound, but some will have no intraarterial pressure gradient across the kink. It is not known whether these nonflow limiting kinks progress further to threaten graft function and should undergo endovascular correction. This is a longitudinal study of conservatively managed arterial kinks to define their natural history. Fourteen patients who had undergone angiography over a 5-year period for suspected TRAS had kinks of the renal artery. True intraarterial pressures were measured in all cases by slow withdrawal of an end-hole catheter after intraarterial injection of a vasodilator. Those with a significant pressure change (≥10% change in peak systolic pressure across the area of suspicion) underwent endovascular treatment. The rest were managed conservatively, with maximal antihypertensive therapy. Outcome of all 14 cases was determined by follow-up of creatinine levels, blood pressure (BP) control and graft outcome over a 3-5-year period (median 4 years). Of the 14 patients with kinks, 10 were male and 4 female; age range 23-67 years (mean 47 years). Eleven had received cadaveric transplants and 3 were allografts; 12 had end-to-side and 2 end-to-end anastomosis, 11/14 cases had an intraarterial pressure ratio of <10% and at median 4 years follow-up on conservative treatment, the serum creatinine of these 11 patients did not differ significantly from those who underwent successful endovascular treatment (mean 118 μmol/l versus 149 μmol/l; p = 0.30, Mann Whitney test). Mean blood pressure was 137/82 mmHg, with a range of 124-155/56-95 mmHg. Only one patient has required an unexplainable increase in antihypertensive medication. Grafts (2/11) were lost and both had chronic rejection on histology. There were no unexplained graft

  18. Carotid artery intima media thickness as a surrogate marker of atherosclerosis in patient with chronic renal failure on hemodialysis

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    Jayanta Paul

    2012-01-01

    Full Text Available Background: In patients with chronic renal failure (CRF, carotid artery intima media thickness (CAIMT is increased when the patients are on hemodialysis. Vascular events caused by atherosclerosis are the major cause of death in patients undergoing hemodialysis. Aims: This study was done to find out the relationship between carotid artery intima media thickness and hemodialysis in chronic renal failure patients independent of classical risk factors and also the relationship between CAIMT of hemodialyzed patients and nonhemodialyzed CRF patients. Materials and Methods: In this observational study, CAIMT of 78 CRF patients was examined by B-mode ultrasonography. Glomerular filtration rate (GFR was calculated by using the "Modification of Diet in Renal Disease" formula. CRF patients, who had been on regular hemodialysis treatment (treated thrice weekly for at least 6 months, were identified as hemodialyzed patients. Data were analyzed by software Statistical package for the social Sciences (SPSS (17 th version. Results: There was significant positive correlation between CAIMT and hemodialysis (P=0.045 independent of traditional risk factors. Hemodialyzed patients had higher mean CAIMT (1136.30±21.21 μm, P<0.001 than mean CAIMT of age and sex matched nondialyzed patients (959.30±23.01 μm. Conclusion: Hemodialysis is an independent risk factor for atherosclerosis in CRF patents. Hemodialyzed patients have significantly higher CAIMT than nondialyzed CRF patients.

  19. Angioplasty of forearm arteries as a finger salvage procedure for patient with end-stage renal failure.

    Science.gov (United States)

    Law, Yuk; Chan, Yiu Che; Cheng, Stephen Wing-Keung

    2016-01-01

    Due to the relatively low metabolic demand and extensive collaterals of the upper limb, peripheral arterial disease seldom leads to tissue loss, except in patients with end-stage renal failure (ESRF), rheumatologic diseases, Raynaud's disease, frostbites, or distal emboli. We report a case of a 51-year-old lady with ESRF who presented to our tertiary referral vascular center with infected gangrene of her right ring finger. Duplex ultrasound showed that her forearm arteries were severely diseased. Digital subtraction angiogram showed severe multilevel stenoses/occlusions in her forearm radial and ulnar arteries. These lesions were successfully angioplastized with 2 mm × 25 mm angioplasty balloon. Completion angiogram showed good radiological results with some post-dilatation spasm which improved with intra-arterial glyceryl trinitrate. The sepsis improved after revascularization, and the distal phalanx was allowed to self-demarcate with dressings and autoamputate with good clinical results. Our case illustrated that even in delayed setting, patients could still benefit from specialist vascular care with a combination of expert care and angioplasty of forearm arteries, with successful salvage of her finger. PMID:27143949

  20. Angioplasty of forearm arteries as a finger salvage procedure for patient with end-stage renal failure

    Science.gov (United States)

    Law, Yuk; Chan, Yiu Che; Cheng, Stephen Wing-Keung

    2016-01-01

    Due to the relatively low metabolic demand and extensive collaterals of the upper limb, peripheral arterial disease seldom leads to tissue loss, except in patients with end-stage renal failure (ESRF), rheumatologic diseases, Raynaud’s disease, frostbites, or distal emboli. We report a case of a 51-year-old lady with ESRF who presented to our tertiary referral vascular center with infected gangrene of her right ring finger. Duplex ultrasound showed that her forearm arteries were severely diseased. Digital subtraction angiogram showed severe multilevel stenoses/occlusions in her forearm radial and ulnar arteries. These lesions were successfully angioplastized with 2 mm × 25 mm angioplasty balloon. Completion angiogram showed good radiological results with some post-dilatation spasm which improved with intra-arterial glyceryl trinitrate. The sepsis improved after revascularization, and the distal phalanx was allowed to self-demarcate with dressings and autoamputate with good clinical results. Our case illustrated that even in delayed setting, patients could still benefit from specialist vascular care with a combination of expert care and angioplasty of forearm arteries, with successful salvage of her finger. PMID:27143949

  1. Berberine ameliorates chronic kidney injury caused by atherosclerotic renovascular disease through the suppression of NFκB signaling pathway in rats.

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    Xin Wan

    Full Text Available BACKGROUND AND OBJECTIVES: Impaired renal function in atherosclerotic renovascular disease (ARD may be the result of crosstalk between atherosclerotic renovascular stenosis and amplified oxidative stress, inflammation and fibrosis. Berberine (BBR regulates cholesterol metabolism and exerts antioxidant effects. Accordingly, we hypothesized that BBR treatment may ameliorate ARD-induced kidney injury through its cholesterol-lowering effect and also suppression of the pathways involved in oxidative stress, inflammation and NFκB activation. METHODS: Male rats were subjected to unilateral renal artery stenosis with silver-irritant coil, and then fed with 12-week hypercholesterolemic diet. Rats with renal artery stenosis were randomly assigned to two groups (n = 6 each - ARD, or ARD+BBR - according to diet alone or in combination with BBR. Similarly, age-matched rats underwent sham operation and were also fed with hypercholesterolemic diet alone or in combination with BBR as two corresponding controls. Single-kidney hemodynamic metrics were measured in vivo with Doppler ultrasound to determine renal artery flow. The metrics reflecting hyperlipidemia, oxidative stress, renal structure and function, inflammation and NFκB activation were measured, respectively. RESULTS: Compared with control rats, ARD rats had a significant increase in urinary albumin, plasma cholesterol, LDL and thiobarbituric acid reactive substances (TBARS and a significant decrease in SOD activity. When exposed to 12-week BBR, ARD rats had significantly lower levels in blood pressure, LDL, urinary albumin, and TBARS. In addition, there were significantly lower expression levels of iNOS and TGF-β in the ARD+BBR group than in the ARD group, with attenuated NFκB-DNA binding activity and down-regulated protein levels of subunits p65 and p50 as well as IKKβ. CONCLUSIONS: We conclude that BBR can improve hypercholesterolemia and redox status in the kidney, eventually ameliorating

  2. 急性皮质下小梗死的影像学特征:大动脉粥样硬化性与小动脉病变性卒中的比较%Imaging features of acute small subcortical infarcts: comparison of large artery atherosclerotic and small artery disease stroke

    Institute of Scientific and Technical Information of China (English)

    李兰玉; 李焰生

    2011-01-01

    目的 探讨大动脉粥样硬化与小动脉病变所致皮质下小梗死(small subcortical infarction,SSI)的影像学差异。方法连续住院的急性SSI患者根据循证缺血性卒中病因分型(SSS- TOAST)标准分为大动脉粥样硬化性卒中组和小动脉闭塞性卒中组,比较其影像学特征。结果共 纳入118例急性SSI患者,剔除7例为心源性脑栓塞,3例为其他明确病因所致卒中,7例为原因不明性 卒中。26例大动脉粥样硬化性卒中组新发梗死灶平均(3.69±5.79)个,50%为多个病灶,以半卵圆中 心为主(P<0.01);75例小动脉闭塞性卒中组新发梗死灶平均(1.08±0.51)个,仅3例(3.7%)为多 个病灶,且位于不同动脉供血区。与大动脉粥样硬化性卒中组相比,小动脉闭塞性卒中组脑白质病变 程度较重(P=0.04)、多伴有无症状梗死(P=0.012)。结论大动脉粥样硬化性SSI多为半卵圆中 心的多发性梗死,而小动脉闭塞性SSI则多为单发性梗死,易伴严重的脑白质病变和无症状梗死。%Objective To investigate the differences in neuroimaging between large artery atherosclerosis and small subcortical infarction (SSI). Methods The consecutive hospitalized patients with acute SSI were divided into large atherosclerotic stroke group and small-artery occlusive stroke group according to the evidence-based etiolologic classification of ischemic stroke (the SSS-TOAST criteria). The neuroimaging features between the two groups were compared.Results A total of 118 patients with SSI were recruited. Seven patients with cardiogenic cerebral embolism were excluded from the study. Three were stroke of other determined etiology and 7 were cryptogenic stroke. Twenty-six patients in the large artery atherosclerotic stroke group had new infarcts (3.69 ± 5. 79), 50% of them were multiple lesions, mainly a half oval in the center (P <0. 01); 75 patients in the small-artery occlusive stroke group had

  3. Glomerular filtration rate measured by 51Cr-EDTA clearance: evaluation of captopril-induced changes in hypertensive patients with and without renal artery stenosis

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    Anna Alice Rolim Chaves

    2010-01-01

    Full Text Available INTRODUCTION: Renal artery stenosis can lead to renovascular hypertension; however, the detection of stenosis alone does not guarantee the presence of renovascular hypertension. Renovascular hypertension depends on activation of the renin-angiotensin system, which can be detected by functional tests such as captopril renal scintigraphy. A method that allows direct measurement of the baseline and post-captopril glomerular filtration rate using chromium-51 labeled ethylenediamine tetraacetic acid (51Cr-EDTA could add valuable information to the investigation of hypertensive patients with renal artery stenosis. The purposes of this study were to create a protocol to measure the baseline and post-captopril glomerular filtration rate using 51Cr-EDTA, and to verify whether changes in the glomerular filtration rate permit differentiation between hypertensive patients with and without renal artery stenosis. METHODS: This prospective study included 41 consecutive patients with poorly controlled severe hypertension. All patients had undergone a radiological investigation of renal artery stenosis within the month prior to their inclusion. The patients were divided into two groups: patients with (n=21 and without renal artery stenosis, (n=20. In vitro glomerular filtration rate analysis (51Cr-EDTA and 99mTc-DMSA scintigraphy were performed before and after captopril administration in all patients. RESULTS: The mean baseline glomerular filtration rate was 48.6±21.8 ml/kg/1.73 m² in the group wuth renal artery stenosis, which was significantly lower than the GFR of 65.1±28.7 ml/kg/1.73m² in the group without renal artery stenosis (p=0.04. Captopril induced a significant reduction of the glomerular filtration rate in the group with renal artery stenosis (to 32.6±14.8 ml/kg/1.73m², p=0.001 and an insignificant change in the group without RAS (to 62.2±23.6 ml/kg/1.73m², p=0.68. Scintigraphy with technetium-99m dimercapto-succinic acid (DMSA did not show

  4. Glomerular filtration rate measured by {sup 51}Cr-EDTA clearance: evaluation of captopril-induced changes in hypertensive patients with and without renal artery stenosis

    Energy Technology Data Exchange (ETDEWEB)

    Chaves, Anna Alice Rolim; Buchpiguel, Carlos Alberto; Praxedes, Jose Nery; Bortolotto, Luiz Aparecido; Sapienza, Marcelo Tatit, E-mail: annaalice100@yahoo.com.b [Universidade de Sao Paulo (USP), SP (Brazil). Faculdade de Medicina. Dept. de Neurologia

    2010-07-01

    Introduction: renal artery stenosis can lead to renovascular hypertension; however, the detection of stenosis alone does not guarantee the presence of renovascular hypertension. Renovascular hypertension depends on activation of the renin-angiotensin system, which can be detected by functional tests such as captopril renal scintigraphy. A method that allows direct measurement of the baseline and post-captopril glomerular filtration rate using chromium-51 labeled ethylenediamine tetraacetic acid ({sup 51}Cr-EDTA) could add valuable information to the investigation of hypertensive patients with renal artery stenosis. The purposes of this study were to create a protocol to measure the baseline and post-captopril glomerular filtration rate using {sup 51}Cr-EDTA, and to verify whether changes in the glomerular filtration rate permit differentiation between hypertensive patients with and without renal artery stenosis. Methods: this prospective study included 41 consecutive patients with poorly controlled severe hypertension. All patients had undergone a radiological investigation of renal artery stenosis within the month prior to their inclusion. The patients were divided into two groups: patients with (n=21) and without renal artery stenosis, (n=20). In vitro glomerular filtration rate analysis ({sup 51}Cr-EDTA) and {sup 99m}Tc-DMSA scintigraphy were performed before and after captopril administration in all patients. Results: the mean baseline glomerular filtration rate was 48.6+-21.8 ml/kg/1.73 m{sup 2} in the group with renal artery stenosis, which was significantly lower than the GFR of 65.1+-28.7 ml/kg/1.73m{sup 2} in the group without renal artery stenosis (p=0.04). Captopril induced a significant reduction of the glomerular filtration rate in the group with renal artery stenosis (to 32.6+-14.8 ml/kg/1.73m{sup 2}, p=0.001) and an insignificant change in the group without RAS (to 62.2+-23.6 ml/kg/1.73m{sup 2}, p=0.68). Scintigraphy with technetium-99m dimercapto

  5. In vivo tracking of magnetically labeled mesenchmal stem cells injected via renal arteries in kidney failure rat

    International Nuclear Information System (INIS)

    Objective: To evaluate in vivo depiction and tracking for magnetically labeled bone marrow mesenchymal stern cells (MSCs) in a renal failure rat model injected intravascularly using a 1.5 T magnetic resonance imaging (MRI) system. Methods: Rat MSCs were isolated, purified, expanded and then incubated with home synthesized Fe2O3-PLL. Prussian blue stain was employed for identifying intracellular irons. An acute renal failure in rat was induced by intramuscular injection of glycerol and MSCs were injected into renal arteries of 11 recipients (labeled cells in six, unlabeled cells in five). MR images of kidneys were obtained respectively before injection of MSCs, and immediately, 1, 3, 5, and 8 clays after transplantation. MR imaging findings were analyzed, which were correlated with histological findings. Results: Rat MSCs were successfully labeled, and labeling efficiency was almost 100%. Prussian blue staining of Fe2O3-PLL labeled cells revealed the presence of iron-containing vesicles or endosomes in the cytoplasm. In the renal failure model of rats, the labeled MSCs were demonstrated as signal intensity loss in renal cortex on T2*-weighted MR images. The signal intensity decrease was visualized up to days 8 after transplantation. Histological analyses showed that most Prussian blue staining-positive cells were well correlated with the area where a signal intensity loss was observed in MRI. Signal intensity decrease was not detected after transplantation of unlabeled cells. Conclusion: The rat MSCs can be effectively labeled with Fe2O3-PLL. 1.5-T MR imaging seems to be a good technique to monitor the magnetically labeled MSCs in vivo in renal failure rat model intravascularly administered, which may have much more potential values for studying the engraftment of stem cells in kidneys. (authors)

  6. Role of high resolution contrast-enhanced magnetic resonance angiography (HR CeMRA) in management of arterial complications of the renal transplant

    International Nuclear Information System (INIS)

    Introduction: Transplant renal artery (RA) stenosis (TRAS) is the most frequent posttransplantation vascular complication. Contrast enhanced magnetic resonance (CeMRA) angiography has been established as the preferred imaging technique for the evaluation of TRAS because it does not require the use of iodinated contrast material and does not expose the patient to ionizing radiation. Digital subtraction angiography (DSA) is the gold standard in the evaluation of arterial tree of the renal allograft. Aim of the work: This study was carried out to assess the accuracy of CeMRA in the detection of arterial complications after renal transplantation. Patients and methods: Thirty renal transplant patients with suspected arterial complications in which both CeMRA and DSA were performed were included in the study. The HR CeMRA shows 93.7% sensitivity, 80% specificity, 88.2% positive predictive value, 88.9% negative predictive value and 88.5% accuracy. Conclusion: HR CeMRA is an accurate reliable tool in the assessment of arterial complications after renal transplantation. It may replace DSA as a diagnostic modality with reservation of interventional techniques for endovascular treatment of suitable cases.

  7. N-acetylcysteine infusion reduces the resistance index of renal artery in the early stage of systemic sclerosis

    Institute of Scientific and Technical Information of China (English)

    Edoardo ROSATO; Rosario CIANCI; Biagio BARBANO; Ginevra MENGHI; Antonietta GIGANTE; Carmelina ROSSI; Enrico M ZARDI; Antonio AMOROSO; Simonetta PISARRI; Felice SALSANO

    2009-01-01

    Aim: To evaluate resistance index (RI) changes in renal artery after N-acetylcysteine infusion in patients with systemic sclerosis. Methods: In an open-label study 40 patients with systemic sclerosis (SSc) were treated with N-acetylcysteine (NAC) iv infusion over 5 consecutive hours, at a dose of 0.015g·kg~(-1)·h~(-1).Renal haemodynamic effects were evaluated by color Doppler examination before and after NAC infusion. Results: NAC infusion significantly reduced RI in a group of sclerodermic patients with early/active capillaroscopic pattern, modified Rodnan Total Skin Score (mRTSS)14 and severe-end stage score to the vascular domain of DSS. In patients with reduction of RI after NAC infusion, diffusion capacity for carbon monoxide mean value was significantly higher than in those patients with an increase of RI. No significant differences in renal blood flow were found between patients with different subsets of SSc. Conclusion: In patients with low disease severity NAC ameliorates vascular renal function.

  8. Accurate perioperative flow measurement of the portal vein and hepatic and renal artery: A role for preoperative MRI?

    Energy Technology Data Exchange (ETDEWEB)

    Vermeulen, Mechteld A.R., E-mail: mar.vermeulen@vumc.nl [Department of Surgery, VU University Medical Center, P.O. Box 7057, 1007 MB Amsterdam (Netherlands); Ligthart-Melis, Gerdien C., E-mail: g.ligthart-melis@vumc.nl [Department of Internal Medicine, Dietetics and Nutritional Sciences, VU University Medical Center, P.O. Box 7057, 1007 MB Amsterdam (Netherlands); Buijsman, René, E-mail: renebuysman@gmail.com [Department of Surgery, VU University Medical Center, P.O. Box 7057, 1007 MB Amsterdam (Netherlands); Siroen, Michiel P.C., E-mail: m.siroen6@upcmail.nl [Department of Surgery, VU University Medical Center, P.O. Box 7057, 1007 MB Amsterdam (Netherlands); Poll, Marcel C.G. van de, E-mail: mcg.vandepoll@ah.unimaas.nl [Department of Surgery, Maastricht University Medical Center, P.O. Box 5800, 6202 AZ Maastricht (Netherlands); Boelens, Petra G., E-mail: p.boelens@mumc.nl [Department of Surgery, Maastricht University Medical Center, P.O. Box 5800, 6202 AZ Maastricht (Netherlands); Dejong, Cornelis H.C., E-mail: chc.dejong@mumc.nl [Department of Surgery, Maastricht University Medical Center, P.O. Box 5800, 6202 AZ Maastricht (Netherlands); Schaik, Cors van, E-mail: c.vanschaik@vumc.nl [Department of Radiology, VU University Medical Center, P.O. Box 7057, 1007 MB Amsterdam (Netherlands); Hofman, Mark B.M., E-mail: mbm.hofman@vumc.nl [Department of Physics and Medical Technology, VU University Medical Center, P.O. Box 7057, 1007 MB Amsterdam (Netherlands); Leeuwen, Paul A.M. van, E-mail: pam.vleeuwen@vumc.nl [Department of Surgery, VU University Medical Center, P.O. Box 7057, 1007 MB Amsterdam (Netherlands)

    2012-09-15

    Background: Quantification of abdominal blood flow is essential for a variety of gastrointestinal and hepatic topics such as liver transplantation or metabolic flux measurement, but those need to be performed during surgery. It is not clear whether Duplex Doppler Ultrasound during surgery or MRI before surgery is the tool to choose. Objective: To examine whether preoperative evaluation of abdominal blood flow using MRI could prove to be a useful and reliable alternative for the perioperative sonographic approach. Methods: In this study portal and renal venous flow and hepatic arterial flow were sequentially quantified by preoperative MRI, preoperative and perioperative Duplex Doppler Ultrasound (DDUS). 55 Patients scheduled for major abdominal surgery were studied and methods and settings were compared. Additionally, average patient population values were compared. Results: Mean (±SD) plasmaflow measured by perioperative DDUS, preoperative DDUS and MRI, respectively was 433 ± 200/423 ± 162/507 ± 96 ml/min (portal vein); 96 ± 70/74 ± 41/108 ± 91 ml/min (hepatic artery); 248 ± 139/201 ± 118/219 ± 69 ml/min (renal vein). No differences between the different settings of DDUS measurement were detected. Equality of mean was observed for all measurements. Bland Altman Plots showed widespread margins. Hepatic arterial flow measurements correlated with each other, but portal and renal venous flow correlations were absent. Conclusions: Surgery and method (DDUS vs. MRI) do not affect mean flow values. Individual comparison is restricted due to wide range in measurements. Since MRI proves to be more reliable with respect to inter-observer variability, we recommend using mean MRI results in experimental setups.

  9. Effect of naringin on hemodynamic changes and left ventricular function in renal artery occluded renovascular hypertension in rats

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    Asjad Visnagri

    2015-01-01

    Full Text Available Background: Renal artery occlusion (RAO induced hypertension is a major health problem associated with structural and functional variations of the renal and cardiac vasculature. Naringin a flavanone glycoside derived possesses metal-chelating, antioxidant and free radical scavenging properties. Objective: The objective of this study was to investigate the antihypertensive activity of naringin in RAO induced hypertension in rats.Material and Methods: Male Wistar rats (180-200 g were divided into five groups Sham, RAO, naringin (20, 40 and 80 mg/kg. Animals were pretreated with naringin (20, 40 and 80 mg/kg p.o for 4 weeks. On the last day of the experiment, left renal artery was occluded with renal bulldog clamp for 4 h. After assessment of hemodynamic and left ventricular function various biochemical (superoxide dismutase [SOD], glutathione [GSH] and malondialdehyde [MDA] and histological parameters were determined in the kidney. Results: RAO group significantly (P < 0.001 increased hemodynamic parameters at 15, 30 and 45 min of clamp removal. Naringin (40 and 80 mg/kg treated groups showed a significant decrease in hemodynamic parameters at 15 min. after clamp removal that remained sustained for 60 min. Naringin (40 and 80 mg/kg treated groups showed significant improvement in left ventricular function at 15, 30 and 45 min after clamp removal. Alteration in level of SOD, GSH and MDA was significantly restored by naringin (40 and 80 mg/kg treatment. It also reduced histological aberration induced in kidney by RAO. Conclusion: It is concluded that the antihypertensive activity of naringin may result through inhibition of oxidative stress.

  10. The giraffe kidney tolerates high arterial blood pressure by high renal interstitial pressure and low glomerular filtration rate

    DEFF Research Database (Denmark)

    Damkjaer, M; Wang, T; Brøndum, E;

    2015-01-01

    adaption in the giraffe kidney allows normal for size renal haemodynamics and glomerular filtration rate (GFR) despite a MAP double that of other mammals. METHODS: Fourteen anaesthetized giraffes were instrumented with vascular and bladder catheters to measure glomerular filtration rate (GFR) and effective......BACKGROUND: The tallest animal on earth, the giraffe (Giraffa camelopardalis) is endowed with a mean arterial blood pressure (MAP) twice that of other mammals. The kidneys reside at heart level and show no sign of hypertension-related damage. We hypothesized that a species-specific evolutionary...

  11. A segmented K-space velocity mapping protocol for quantification of renal artery blood flow during breath-holding

    DEFF Research Database (Denmark)

    Thomsen, C; Cortsen, M; Söndergaard, L;

    1995-01-01

    segmented k-space technique, in which the entire data acquisition can be made within a breath-hold by the sampling of several phase-encoding lines within a small time window during each heart cycle. The aim of this study was to investigate the performance of a segmented k-space velocity mapping protocol for...... renal artery flow determination. The protocol uses 16 phase-encoding lines per heart beat during 16 heart cycles and gives a temporal velocity resolution of 160 msec. Comparison with a conventional ECG-triggered velocity mapping protocol was made in phantoms as well as in volunteers. In our study, both...

  12. Multiple detector-row CT angiography of the renal and mesenteric vessels

    International Nuclear Information System (INIS)

    Computed tomography angiography (CTA) of the abdomen with multiple detector-row computed tomography (MD-CT) is an effective technique for minimally invasive imaging of the renal arteries and the visceral vasculature. This article reviews the clinical and technical aspects of MD-CT angiography in terms of image acquisition and reconstruction parameters, contrast medium application, and three-dimensional visualization with special attention to renal and mesenteric vascular imaging. Because of its high sensitivity to detect renal artery stenosis on the one hand, and because a normal renal CTA virtually excludes the presence of a significant renal artery stenosis on the other hand, renal CTA plays a useful role in the management of patients with suspected renovascular hypertension. Mesenteric CTA is a useful tool for visualizing normal vascular anatomy and its variants--particularly in the setting of organ transplantation. Vascular pathology, e.g. atherosclerotic disease (abdominal angina), or aneurysms of the visceral arteries are reliably assessed with CTA. Mesenteric CTA is an invaluable adjunct to abdominal CT in the setting of abdominal emergencies, because of its ability to detect the causes of acute intestinal ischemia (superior mesenteric artery embolism or thrombosis, superior mesenteric vein thrombosis). Accurate timing of the CTA acquisition and the subsequent parenchymal phase acquisition relative to the contrast medium transit time is critical to obtain excellent image quality in double-pass abdominal CT acquisitions

  13. Effects of allopurinol and vitamin E on renal function in patients with cardiac coronary artery bypass grafts

    Directory of Open Access Journals (Sweden)

    Nader Nouri-Majalan

    2009-05-01

    Full Text Available Nader Nouri-Majalan1, Ehsan Fotouhi Ardakani2, Khalil Forouzannia3, Hosein Moshtaghian41Department of Nephrology, 3Department of Cardiovascular Surgery, 4Department of Anesthesiology, Afshar Hospital, Shahid Sadoughi University of Medical Sciences, Yazd, Iran; 2Ali bin Abu Taleb Medical College, Yazd Azad University, Yazd, IranBackground: Acute renal failure is a common complication of cardiac surgery, with oxidants found to play an important role in renal injury. We therefore assessed whether the supplemental antioxidant vitamin E and the inhibitor of xanthine oxidase allopurinol could prevent renal dysfunction after coronary artery bypass graft (CABG surgery.Methods: Of 60 patients with glomerular filtration rate (GFR < 60 mL/min scheduled to undergo CABG surgery, 30 were randomized to treatment with vitamin E and allopurinol for 3–5 days before surgery and 30 to no treatment. Serum creatinine levels and potassium and creatinine clearances were measured preoperatively and daily until day 5 after surgery. Results: The patients consisted of 31 males and 29 females, with a mean age of 63 ± 9 years. After surgery, there were no significant differences in mean serum creatinine (1.2 ± 0.33 vs 1.2 ± 0.4 mg/dL; p = 0.43 concentrations, or creatinine clearance (52 ± 12.8 vs 52 ± 12.8 mL/min; p = 0.9. The frequency of acute renal failure did not differ in treatment group compared with control (16% vs 13%; p = 0.5. Length of stay in the intensive care unit (ICU was significantly longer in the control than in the treated group (3.9 ± 1.5 vs 2.6 ± 0.7 days; p < 0.001.Conclusion: Prophylactic treatment with vitamin E and allopurinol had no renoprotective effects in patients with pre-existing renal failure undergoing CABG surgery. Treatment with these agents, however, reduces the duration of ICU stay.Keywords: antioxidants, coronary artery bypass, prevention and control, renal function

  14. Knowledge and attitude of physicians in a major teaching hospital towards atherosclerotic risk reduction therapy in patients with peripheral arterial disease

    OpenAIRE

    Al-Omran, Mohammed

    2007-01-01

    Background Peripheral arterial disease (PAD) is a marker of advanced atherosclerosis with an elevated risk of cardiovascular mortality and morbidity. Although intensive risk reduction therapy is critical in reducing the adverse cardiovascular outcomes in patients with PAD, the awareness of this information among all physicians is felt to be low. Given the role of family physicians (FP), general internists (GI), cardiologists (C), and vascular surgeons (VS) in treating patients with PAD, we so...

  15. Inter-study reproducibility of arterial spin labelling magnetic resonance imaging for measurement of renal perfusion in healthy volunteers at 3 Tesla

    OpenAIRE

    Gillis, Keith A.; McComb, Christie; Foster, John E.; Taylor, Alison; Patel, Rajan K.; Morris, Scott; Alan G. Jardine; Schneider, Markus P; Roditi, Giles H; Delles, Christian; Mark, Patrick B.

    2014-01-01

    Background: Measurement of renal perfusion is a crucial part of measuring kidney function. Arterial spin labelling magnetic resonance imaging (ASL MRI) is a non-invasive method of measuring renal perfusion using magnetised blood as endogenous contrast. We studied the reproducibility of ASL MRI in normal volunteers. Methods: ASL MRI was performed in healthy volunteers on 2 occasions using a 3.0 Tesla MRI scanner with flow-sensitive alternating inversion recovery (FAIR) perfusion prep...

  16. Ultrasound Tissue Characterization of Vulnerable Atherosclerotic Plaque

    Directory of Open Access Journals (Sweden)

    Eugenio Picano

    2015-05-01

    Full Text Available A thrombotic occlusion of the vessel fed by ruptured coronary atherosclerotic plaque may result in unstable angina, myocardial infarction or death, whereas embolization from a plaque in carotid arteries may result in transient ischemic attack or stroke. The atherosclerotic plaque prone to such clinical events is termed high-risk or vulnerable plaque, and its identification in humans before it becomes symptomatic has been elusive to date. Ultrasonic tissue characterization of the atherosclerotic plaque is possible with different techniques—such as vascular, transesophageal, and intravascular ultrasound—on a variety of arterial segments, including carotid, aorta, and coronary districts. The image analysis can be based on visual, video-densitometric or radiofrequency methods and identifies three distinct textural patterns: hypo-echoic (corresponding to lipid- and hemorrhage-rich plaque, iso- or moderately hyper-echoic (fibrotic or fibro-fatty plaque, and markedly hyperechoic with shadowing (calcific plaque. Hypoechoic or dishomogeneous plaques, with spotty microcalcification and large plaque burden, with plaque neovascularization and surface irregularities by contrast-enhanced ultrasound, are more prone to clinical complications than hyperechoic, extensively calcified, homogeneous plaques with limited plaque burden, smooth luminal plaque surface and absence of neovascularization. Plaque ultrasound morphology is important, along with plaque geometry, in determining the atherosclerotic prognostic burden in the individual patient. New quantitative methods beyond backscatter (to include speed of sound, attenuation, strain, temperature, and high order statistics are under development to evaluate vascular tissues. Although not yet ready for widespread clinical use, tissue characterization is listed by the American Society of Echocardiography roadmap to 2020 as one of the most promising fields of application in cardiovascular ultrasound imaging

  17. Intramural hemorrhage and endothelial changes in atherosclerotic coronary artery after repetitive episodes of spasm in x-ray-irradiated hypercholesterolemic pigs

    International Nuclear Information System (INIS)

    To assess whether coronary spasm affects the progression of atherosclerosis and results in evolution of myocardial infarction, the role of coronary spasm on the fine structure of conduit coronary arteries was studied morphologically. Goettingen miniature pigs were fed a semisynthetic diet containing 2% cholesterol and 1.1% sodium cholate. One month after being on this diet, the pigs were anesthetized and the endothelium of a branch of the left coronary artery was denuded using a balloon catheter. X-ray irradiation in a dose of 1,500 rad was given twice selectively to the area denuded, after 4 and 5 months of cholesterol feeding. Five months after endothelial denudation, transient (group A) and repetitive episodes (group B) of coronary spasm were provoked by single and periodic (five times every 5 minutes) intracoronary injections of serotonin (10 micrograms/kg/injection), respectively. The extent of spasm by serotonin at the previously denuded site was 84 +/- 4% (n = 4) and 90 +/- 5% (n = 6) narrowing in groups A and B (p = NS between groups), respectively. Forty minutes after the final administration of serotonin, the left coronary artery was relaxed by nitroglycerin, and the heart was isolated and perfuse-fixed under physiological pressure. Intramural hemorrhage was noted at the spastic site in six pigs of group B but not in group A. The average percent luminal narrowing, on cross sections at the spastic site in group B, was significantly greater than in group A (56 +/- 7% vs. 23 +/- 5%, p less than 0.01). Scanning electron micrographs revealed that the endothelial lining was intact at the nonspastic site in both groups. In addition to the appearance of intercellular bridges at the spastic site in both groups, squeezing of endothelial cells and adhesion of white blood cells were present at the spastic site exclusively in group B

  18. The feasibility of spatial high-resolution magnetic resonance angiography (MRA) of the renal arteries at 3.0 T

    International Nuclear Information System (INIS)

    Purpose: to evaluate the feasibility of high-spatial resolution magnetic resonance angiography (MRA) of the renal arteries at 3.0 T. Material and methods: twelve healthy volunteers (mean age, 38.8 years) underwent renal MRA at 3.0 T. The application of parallel imaging with an acceleration factor of 3 allowed obtaining MR angiographic data with a voxel size of 0.9 x 0.8 x 0.9 mm in scan time of only 16 s. A dose of 0.2 mmol/kg body weight of 0.5-molar gadodiamide was administered at a flow rate of 2 ml/s. For image analysis, image quality, presence of artifacts, venous contamination and level of noise were rated by two radiologists in consensus. Results: all examinations were of diagnostic quality. The image quality was rated good or very good in 91% (11/12) of cases. Due to the high parallel imaging factor the level of noise was slightly increased without diagnostic impairment. Mild venous enhancement was found in 75% (9/12) of the examinations. Conclusion: renal MRA at 3.0 T is feasible with high spatial resolution and a short acquisition time. (orig.)

  19. Detection of an acute occlusion of the renal artery in a kidney transplant using sup(99m)Tc-DTPA sequential scintiscanning

    International Nuclear Information System (INIS)

    131I-hippurane isotope nephrography is a well-tried method to control the function of a kidney transplant. The method is well suited for an early observation of shedding crises. In addition, glomerullary filtered sup(99m)Tc-DTPA may be used to detect vascular complications (renal arteriostenosis, occlusion of renal arteries, renal venal thromboses, aneurysm) and disturbances of the potrenal outflow. Vascular complications in kidney transplants shortly after surgery are possible; they require a quick and precise diagnosis. Perfusion analysis with the aid of sup(99m)Tc-DTPA as a non-invasive and hardly exerting method is frequently used for diagnosis of this kind. (orig.)

  20. Evaluation of the Correlation Between Myocardial Bridging and Atherosclerotic Changes in Coronary Artery Segment Proximal to the Bridge by 64-Slice Multidetector CT Scan

    Directory of Open Access Journals (Sweden)

    Safa Hoodeshenas

    2011-05-01

    Full Text Available Background/Objective: The aim of this study was"nto evaluate the prevalance and characteristics of myocardial bridging (MB and to assess the correlation"nbetween atherosclerosis and MB."nMaterials and Methods: Retrospective evaluation"nof 2790 coronary angiograms were obtained by 64-"nslice multidetector CT. The prevalance, length, depth,"nprecise of MB location and concomitant atherosclerosis"nproximal to tunneled segment were evaluated. The"ngroup of subjects with MB was compared with the"ncontrol group (subjects without MB."nResults: Of the 2790 subjects, 548 (19.64% were"nfound to have MB. MB was present equally in men"nand women. The tunneled segment was intact in"nall subjects. A negative significant correlation was"nfound between the presence of MB and severity of"natherosclerosis in the proximal segment of the coronary"nartery (p<0.001; df=2×2=42.75. The mid LAD was the"nmost common coronary artery involved. The severity"nof atherosclerosis in the part proximal to the tunneled"nsegment correlated with the thickness of bridge"n(p=0.035, but no significant correlation was found"nwith the length of the bridged segment (p=0.431."nConclusion: The myocardial bridge not only does not"npredispose to the development of atherosclerosis in"nthe coronary artery segment proximal to the bridge,"nbut may also be a protective factor.

  1. The evaluation of primary stenting of sirolimus-eluting versus bare-metal stents in the treatment of atherosclerotic lesions of crural arteries.

    Science.gov (United States)

    Falkowski, Aleksander; Poncyljusz, Wojciech; Wilk, Grazyna; Szczerbo-Trojanowska, Małgorzata

    2009-04-01

    A comparison was made of sirolimus-eluting stents and bare stents as an effective means of treatment of stenosis in crural arteries. Patients were randomly divided into two groups: (1) patients treated with sirolimus-eluting stents and (2) patients treated with bare stents. Each group consisted of 25 patients, and every patient had one stent implanted. All patients showed symptoms of ischemia of the peripheral arteries, classified according to the Rutherford scale into categories 3, 4, and 5. All patients were examined 24 h before and 24 h and 6 months after the intervention. The results were analyzed according to clinical, hemodynamic, and angiographic criteria. Technically, the procedure was successful in 100% of cases, and both groups presented an equal improvement in clinical and hemodynamic parameters. The follow-up angiographic examination demonstrated a significantly lower rate of restenosis among the sirolimus-eluting stent group (4, 16%) versus the bare stent group (19, 76%) (p < 0.001), with lower target lesion revascularization in 3 (12%) versus 14 (56%) (p < 0.05), respectively. Quantitative angiography demonstrated that all variables used to assess restenosis were superior for sirolimus-eluting stents 6 months after intervention: late lumen loss 0.46 +/- 0.72 versus 1.70 +/- 0.94 (p < 0.001) and minimal lumen diameter 2.25 +/- 0.82 versus 0.99 +/- 1.08 (p < 0.001). Results of this study reveal that the use of sirolimus-eluting stents decreases the risk of restenosis in comparison to standard stents. PMID:19034460

  2. The evaluation of primary stenting of sirolimus-eluting versus bare-metal stents in the treatment of atherosclerotic lesions of crural arteries

    Energy Technology Data Exchange (ETDEWEB)

    Falkowski, Aleksander; Wilk, Grazyna [Pomeranian Medical University of Szczecin, Departament of General and Dental Diagnostic Imaging, Szczecin (Poland); Poncyljusz, Wojciech [Pomeranian Medical University of Szczecin, Departament of Diagnostic Imaging and Interventional Radiology, Szczecin (Poland); Szczerbo-Trojanowska, Malgorzata [Medical University of Lublin, Department of Interventional Radiology and Neuroradiology, Lublin (Poland)

    2009-04-15

    A comparison was made of sirolimus-eluting stents and bare stents as an effective means of treatment of stenosis in crural arteries. Patients were randomly divided into two groups: (1) patients treated with sirolimus-eluting stents and (2) patients treated with bare stents. Each group consisted of 25 patients, and every patient had one stent implanted. All patients showed symptoms of ischemia of the peripheral arteries, classified according to the Rutherford scale into categories 3, 4, and 5. All patients were examined 24 h before and 24 h and 6 months after the intervention. The results were analyzed according to clinical, hemodynamic, and angiographic criteria. Technically, the procedure was successful in 100% of cases, and both groups presented an equal improvement in clinical and hemodynamic parameters. The follow-up angiographic examination demonstrated a significantly lower rate of restenosis among the sirolimus-eluting stent group (4, 16%) versus the bare stent group (19, 76%) (p < 0.001), with lower target lesion revascularization in 3 (12%) versus 14 (56%) (p < 0.05), respectively. Quantitative angiography demonstrated that all variables used to assess restenosis were superior for sirolimus-eluting stents 6 months after intervention: late lumen loss 0.46 {+-} 0.72 versus 1.70 {+-} 0.94 (p < 0.001) and minimal lumen diameter 2.25 {+-} 0.82 versus 0.99 {+-} 1.08 (p < 0.001). Results of this study reveal that the use of sirolimus-eluting stents decreases the risk of restenosis in comparison to standard stents. (orig.)

  3. HIPERTENSÃO ARTERIAL NA DOENÇA RENAL CRÔNICA EM PEQUENOS ANIMAIS: REVISÃO DE LITERATURA

    Directory of Open Access Journals (Sweden)

    GALVÃO, André Luiz Baptista

    2010-05-01

    Full Text Available Chronic kidney disease (CKD is characterized by irreversible structural lesions can developprogressively for uremia and chronic renal failure (CRF. After first renal lesion, occur structural and functionalalterations in remaining nephrons, with objective to maintain homeostasis, mainly for the volume and thecomposition fluid extracell. Systemic hypertension is the most important cardiovascular complications in CKDin the dogs and cats. Organs more affected by hypertension are these involved in the regulation sanguine flow(heart and others that contain extensive arteriolares or capillary nets (eyes, brain, kidneys. In the kidneyshypertension is associated with proteinuria presence and progression glomerular damage. This way, the objectivethis literary revision was to describe systemic alterations related with the involvement chronic renal disease witharterial hypertension, as well as your pathophysiology, resources in diagnosis, conducts and therapeutic optionsfor be use in the patient.A doença renal crônica (DRC é caracterizada por lesões estruturais irreversíveis, que podemevoluir progressivamente para uremia e falência renal. Após a instalação inicial da lesão renal, ocorremmudanças estruturais e funcionais adaptativas dos néfrons remanescentes, na tentativa de manter a homeostase,principalmente quanto à regulação do volume e da composição do fluido corporal extracelular. A hipertensãosistêmica é uma das complicações cardiovasculares mais frequentemente reconhecidas da DRC em cães e gatos.Os órgãos mais afetados pela hipertensão são os que estão envolvidos na regulação do fluxo sanguíneo (coraçãoe os que contêm extensas redes arteriolares ou capilares (olhos, cérebro, rins. Nos rins a hipertensão estaassociada a presença de proteinúria e progressão de dano glomerular. Desse modo, apresentamos esta revisão deliteratura com objetivo de descrever as alterações sistêmicas relacionadas com o envolvimento da

  4. Early Biomarkers of Renal Damage in Relation to Arterial Stiffness and Inflammation in Male Coronary Artery Disease Patients

    Directory of Open Access Journals (Sweden)

    Kaido Paapstel

    2016-07-01

    Full Text Available Background/Aims: Plasma neutrophil gelatinase-associated lipocalin (NGAL, urinary liver-type fatty acid-binding protein (L-FABP and urinary kidney injury molecule-1 (KIM-1 have emerged as promising biomarkers for both acute and chronic kidney injury that also provide prognostic value for cardiovascular morbidity and mortality. Our aim was to evaluate their relationships with arterial stiffness and inflammation in coronary artery disease (CAD patients and in clinically healthy controls. Methods: We studied 52 patients with CAD (age 63.2 ± 9.2 years and 41 healthy controls (age 60.1 ± 7.2 years. Urinary L-FABP and KIM-1 as well as serum NGAL, adiponectin and resistin levels were measured using the enzyme-linked immunosorbent assay method. The technique of applanation tonometry was used for non-invasive pulse wave analysis and pulse wave velocity assessments. Results: Urinary L-FABP and KIM-1 were independent determinants of cf-PWV for the CAD patients (R2=0.584, Pr=0.31, P=0.028 only for the patients, while NGAL correlated with WBC count (rho=0.29, P=0.038; r=0.35, P=0.029 and resistin (rho=0.60, PConclusion: Our findings suggest that urinary L-FABP and KIM-1 may be independently associated with aortic stiffness in individuals with CAD.

  5. Effects of chronic renal failure rat serum on histone acetyltransferase p300 and activation of activating transcription factor 4 of arterial smooth muscle cells cultured in vitro

    Institute of Scientific and Technical Information of China (English)

    张耀全

    2014-01-01

    Objective To investigate the effects of the rat serum with chronic renal failure(CRF)on ubiquitin-proteasome pathway,histone acetyltransferase p300 and activation of activating transcription factor 4(ATF4)of rat arterial vascular smooth muscle cells(VSMCs)cultured in vitro,and explore the possible mechanism.Methods Objective To establish the rat model of

  6. Three-Dimensional Rotational Angiography of Transplanted Renal Arteries: Influence of an Extended Angle of Rotation on Beam-Hardening Artifacts

    International Nuclear Information System (INIS)

    Purpose: To investigate whether three-dimensional rotational angiography (3D-RA) of the transplant renal artery performed with an extended angle of rotation can reduce beam-hardening artifacts in 3D reconstructed images without image quality being lost or side effects to the transplanted kidney being increased. Material and Methods: 3D-RA with a C-arm rotation of 180 deg was performed consecutively in 12 renal transplanted patients with suspicion of renal artery stenosis. A 1.7-mm balloon occlusion catheter was placed using the crossover technique and this was compared to a protocol with 160 deg rotation and a traditional 1.4-mm catheter in 10 patients. The occurrence of beam-hardening artifacts was registered and the effects of the reduced contrast load on image quality and of arterial occlusion on renal function were assessed. Results: The extended angle of rotation, from 160 deg to 180 deg, reduced the beam-hardening artifacts. Artifacts were observed in 4/11 patients (36%) in the study group and in all 10 (100%) of the controls. There was no statistical difference regarding image quality between the two protocols. Renal function was equally affected in both protocols. Conclusion: 3D-RA with an extended C-arm rotation reduced the beam-hardening artifacts. Image quality was not reduced despite the reduced contrast medium load. The different protocols had no effect on patient outcome

  7. Identification of atherosclerotic plaque components with intravascular ultrasound elastography in vivo: a Yucatan pig study.

    NARCIS (Netherlands)

    Korte, C.L. de; Sierevogel, M.J.; Mastik, F.; Strijder, C.; Schaar, J.A.; Velema, E.; Pasterkamp, G.; Serruys, P.W.; Steen, A.F.W. van der

    2002-01-01

    BACKGROUND: Intravascular ultrasound elastography assesses the local strain of the atherosclerotic vessel wall. In the present study, the potential to identify different plaque components in vivo was investigated. METHODS AND RESULTS: Atherosclerotic external iliac and femoral arteries (n=24) of 6 Y

  8. Ultrafast laser ablation for targeted atherosclerotic plaque removal

    Science.gov (United States)

    Lanvin, Thomas; Conkey, Donald B.; Descloux, Laurent; Frobert, Aurelien; Valentin, Jeremy; Goy, Jean-Jacques; Cook, Stéphane; Giraud, Marie-Noelle; Psaltis, Demetri

    2015-07-01

    Coronary artery disease, the main cause of heart disease, develops as immune cells and lipids accumulate into plaques within the coronary arterial wall. As a plaque grows, the tissue layer (fibrous cap) separating it from the blood flow becomes thinner and increasingly susceptible to rupturing and causing a potentially lethal thrombosis. The stabilization and/or treatment of atherosclerotic plaque is required to prevent rupturing and remains an unsolved medical problem. Here we show for the first time targeted, subsurface ablation of atherosclerotic plaque using ultrafast laser pulses. Excised atherosclerotic mouse aortas were ablated with ultrafast near-infrared (NIR) laser pulses. The physical damage was characterized with histological sections of the ablated atherosclerotic arteries from six different mice. The ultrafast ablation system was integrated with optical coherence tomography (OCT) imaging for plaque-specific targeting and monitoring of the resulting ablation volume. We find that ultrafast ablation of plaque just below the surface is possible without causing damage to the fibrous cap, which indicates the potential use of ultrafast ablation for subsurface atherosclerotic plaque removal. We further demonstrate ex vivo subsurface ablation of a plaque volume through a catheter device with the high-energy ultrafast pulse delivered via hollow-core photonic crystal fiber.

  9. Role of the Rostral Ventrolateral Medulla in the Arterial Hypertension in Chronic Renal Failure

    OpenAIRE

    Adriana P. Castilho Dugaich; Oliveira-Sales, Elizabeth B.; Abreu, Nayda P.; Mirian A. Boim; Cássia T. Bergamaschi; Campos, Ruy R.

    2010-01-01

    Sympathetic activation in chronic renal failure (CRF) is a major mechanism leading to the progression of renal disease and hypertension. In the present study, we tested the hypothesis that in CRF increased reactive oxygen species (ROS) production in the RVLM mediated by enhanced circulating Angiotensin II (Ang II) is an important mechanism leading to hypertension in CRF. In CRF rats we found an increase in the abundance of p47phox and gp91phox mRNA within the RVLM associated with a reduction ...

  10. In vivo and in vitro evidence that 99mTc-HYNIC-interleukin-2 is able to detect T lymphocytes in vulnerable atherosclerotic plaques of the carotid artery

    International Nuclear Information System (INIS)

    Recent advances in basic science have established that inflammation plays a pivotal role in the pathogenesis of atherosclerosis. Inflammatory cells are thought to be responsible for the transformation of a stable plaque into a vulnerable one. Lymphocytes constitute at least 20 % of infiltrating cells in these vulnerable plaques. Therefore, the interleukin-2 (IL-2) receptor, being overexpressed on activated T lymphocytes, may represent an attractive biomarker for plaque vulnerability. The aim of this study was to evaluate the specificity of radiolabelled IL-2 [99mTc-hydrazinonicotinamide (HYNIC)-IL-2] for imaging the lymphocytic infiltration in carotid plaques in vivo by planar and single photon emission computed tomography (SPECT)/CT imaging and ex vivo by microSPECT and autoradiography. For the in vivo study, ten symptomatic patients with advanced plaques at ultrasound who were scheduled for carotid endarterectomy underwent 99mTc-HYNIC-IL-2 scintigraphy. The images were analysed visually on planar and SPECT images and semi-quantitatively on SPECT images by calculating target to background (T/B) ratios. After endarterectomy, immunomorphological evaluation and immunophenotyping were performed on plaque slices. For the ex vivo studies, four additional patients were included and, after in vitro incubation of removed plaques with 99mTc-HYNIC-IL-2, autoradiography was performed and microSPECT images were acquired. Visual analysis defined clear 99mTc-HYNIC-IL-2 uptake in seven of the ten symptomatic plaques. SPECT/CT allowed visualization in eight of ten. A significant correlation was found between the number of CD25+ lymphocytes and the total number of CD25+ cells in the plaque and the T/B ratio with adjacent carotid artery as background (Pearson's r = 0.89, p = 0.003 and r = 0.87, p = 0.005, respectively). MicroSPECT imaging showed clear 99mTc-HYNIC-IL-2 uptake within the plaque wall and not in the lipidic core. With autoradiography, only CD3+ lymphocytes were found to

  11. RETROSPECTIVE STUDY OF MORPHOLOGICAL AND EVOLUTIVE PARTICULARITIES OF ATHEROSCLEROTIC LESIONS

    Directory of Open Access Journals (Sweden)

    Elena Cojocaru

    2010-08-01

    Full Text Available Atherosclerosis is not a simple vascular senescence process, but also is a progressive and high risk disease. From morphologic point of vue it can be found a large variety of atherosclerotic lesions depending on their evolution and localization. The aim of this study was to investigate and to correlate clinical and evolutive aspects of the atherosclerotic process, regarding 213 patients of Cardiovascular Department of Cardiovascular Disease Institute ``Prof. Dr. George IM Georgescu``, Iaşi, which have been investigated for a period during 2005-2009. The arterial fragments from both muscular and elastic types of arteries were prelevated by endarterectomy and were specifically prepared for histopathological exam. The microscopic exam revealed the high frequency of advanced atherosclerotic lesions, especially type V and type VI in a positive correlation with age, sex, clinical diagnostic and other associated risk factors.

  12. Increased ADRP expression in human atherosclerotic lesions correlates with plaque instability

    OpenAIRE

    Xu, Bin; Zhao, Huiying; Wang, Shengnan; Sun, Xiwei; Qin, Xiujiao

    2015-01-01

    Adipose differentiation-related protein (ADRP) is intrinsically associated with the surface of lipid droplets implicated in the development of atherosclerosis. We analyzed expression of ADRP in human popliteal artery plaques. Atherosclerotic plaque tissue from the popliteal artery was obtained from 18 patients undergoing lower extremity amputation for arteriosclerosis obliterans, and with either stable (n = 6) or unstable (n = 12) atherosclerotic plaques. Plaques were histologically classifie...

  13. [Hypertension and renal disease

    DEFF Research Database (Denmark)

    Kamper, A.L.; Pedersen, E.B.; Strandgaard, S.

    2009-01-01

    hypertension. Mild degrees of chronic kidney disease (CKD) can be detected in around 10% of the population, and detection is important as CKD is an important risk factor for atherosclerotic cardiovascular disease. Conversely, heart failure may cause an impairment of renal function. In chronic progressive......Renal mechanisms, in particular the renin-angiotensin system and renal salt handling, are of major importance in blood pressure regulation. Co-existence of hypertension and decreased renal function may be due to nephrosclerosis secondary to hypertension, or primary renal disease with secondary...

  14. The Relationship Between Osteoprotegerin/RANKL Axis and Arterial Stiffness in Osteopenic/Osteoporotic Renal Transplantation Recipients

    Directory of Open Access Journals (Sweden)

    İsmail KOÇYIĞI

    2015-09-01

    Full Text Available OBJECTIVE: Cardiovascular diseases are the main reason of death in patients with renal transplantation (Rtx. Osteoprotegerin (OPG is produced by osteoblasts and is linked to increased cardiovascular risk in Rtx. OPG acts as a decoy receptor binding receptor activator of nuclear factor kappa-B ligand (RANKL and this interaction plays a role in bone resorption and vascular function. This study aimed to investigate the relation between OPG, RANKL, osteoporosis and arterial stiffness in Rtx patients. MATERIAL and METHODS: This cross-sectional study included 80 adult Rtx recipients. Femoral neck mineral density was obtained by dual-energy X-ray absorptiometry. Serum OPG and RANKL were measured by the ELISA method. Pulse-wave analysis was measured in the carotid and femoral arteries using a pulse wave velocity (PWV machine. RESULTS: Patients were divided into two groups as normal (n:24 and osteopenia/osteoporosis group (n:56. Body mass index was significantly lower in the osteopenic/osteoporotic group compared to the normal group. Pulse wave velocity was positively correlated with age (r:0.204,p:0.072, osteoprotegerin (r:0.219,p:0.052, calcium x phosphate product (r:0.605,p:<0.001, and systolic blood pressure (r:0.198,p:0.058 and negatively correlated with RANKL (r:-0.261,p:0.020 and creatinine clearance (r:-0.220,p:0.051. PWV was independently predicted by calcium x phosphate product but not creatinine clearance, RANKL, osteoprotegerin and systolic blood pressure. CONCLUSION: In our study, serum calcium x phosphate product but not OPG and RANKL levels were found to be the main predictor of arterial stiffness in Rtx patients.

  15. ATHEROSCLEROTIC CARDIOVASCULAR DISEASE IN OLDER ADULTS WITH DIABETES MELLITUS

    OpenAIRE

    Barzilay, Joshua I.; Mukamal, Kenneth J.; Kizer, Jorge R.

    2014-01-01

    Diabetes Mellitus exerts a strong effect on atherosclerotic cardiovascular disease risk into older age (beyond ages 70 to 74 years). This effect is particularly noticeable with regard to coronary artery disease and cerebral microvascular disease. Thus Diabetes Mellitus in older age deserves the same careful medical attention as it does in middle age.

  16. Calcification Locates to Transglutaminases in Advanced Human Atherosclerotic Lesions

    OpenAIRE

    2009-01-01

    Transglutaminases play an important role in vascular smooth muscle cell-induced calcification in vitro. In this study, we determined whether these enzymes are also involved in human atherosclerotic calcification using nine carotid artery specimens obtained at endarterectomy. Sections of the carotid artery specimens were registered to micro-computed tomography images and stained for tissue-type transglutaminase, plasma transglutaminase factor XIIIA (FXIIIA), the Nε(γ-glutamyl)lysine cross-link...

  17. Transcatheter renal denervation for the treatment of resistant arterial hypertension: the Swiss expert consensus

    OpenAIRE

    Wuerzner, Gregoire; Muller, Olivier; Erne, Paul; Cook, Stéphane; Sudano, Isabella; Lüscher, Thomas F.; Noll, Georg; Kaufmann, Urs; Rickli, Hans; Waeber, Bernard; Kaiser, Christophe; Sticherling, Christian; Pechère-Bertschi, Antoinette; Baumgartner, Iris; Jacob, Augustinus L

    2014-01-01

    Transcatheter (or percutaneous) renal denervation is a novel technique developed for the treatment of resistant hypertension. So far, only one randomised controlled trial has been published, which has shown a reduction of office blood pressure. The Swiss Society of Hypertension, the Swiss Society of Cardiology, The Swiss Society of Angiology and the Swiss Society of Interventional Radiology decided to establish recommendations to practicing physicians and specialists for good clinical practic...

  18. Antagonism of Ca2+ influx via L-type Ca2+ channels mediates the vasorelaxant effect of Catharanthus roseus-derived vindorosine in rat renal artery.

    Science.gov (United States)

    Wu, Xiao-Lin; Cheang, Wai San; Zhang, Dong-Mei; Li, Yong; Lau, Chi-Wai; Wang, Guo-Cai; Huang, Yu; Ye, Wen-Cai

    2014-12-01

    Catharanthus roseus is a traditional herbal medicine used in Asian and African countries for the treatment of various diseases including hypertension. The present study examined possible cellular mechanisms for the relaxation of rat renal arteries induced by vindorosine extracted from C. roseus. Intrarenal arteries were isolated from 200-300 g male Sprague-Dawley rats and treated with different pharmacological blockers and inhibitors for the measurement of vascular reactivity on a Multi Myograph System. Fluorescence imaging by laser scanning confocal microscopy was utilized to determine the intracellular Ca(2+) level in the vascular smooth muscles of the renal arteries. Vindorosine in micromolar concentrations relaxes renal arteries precontracted by KCl, phenylephrine, 11-dideoxy-9α,11α-epoxymethanoprostaglandin F2α, and serotonin. Vindorosine-induced relaxations were unaffected by endothelium denudation or by treatment with the nitric oxide synthase inhibitor N (G)-nitro-L-arginine methyl ester hydrochloride, the guanylyl cyclase inhibitor 1H-[1, 2, 4]oxadiazolo[4,3-a]quinoxalin-1-one, the cyclooxygenase inhibitor indomethacin, or K(+) channel blockers such as tetraethylammonium ions, glibenclamide, and BaCl2. Vindorosine-induced relaxations were attenuated in the presence of 0.1 µM nifedipine (an L-type Ca(2+) channel blocker). Vindorosine also concentration-dependently suppressed contractions induced by CaCl2 (0.01-5 mM) in Ca-free 60 mM KCl solution. Furthermore, fluorescence imaging using fluo-4 demonstrated that 30 min incubation with 100 µM vindorosine reduced the 60 mM KCl-stimulated Ca(2+) influx in the smooth muscles of rat renal arteries. The present study is probably the first report of blood vessel relaxation by vindorosine and the possible underlying mechanisms involving the inhibition of Ca(2+) entry via L-type Ca(2+) channels in vascular smooth muscles. PMID:25340466

  19. Trombólise tardia e espontânea de artéria renal sem comprometimento funcional Late and spontaneous thrombolysis of renal artery without functional impairtment

    OpenAIRE

    Claudio Pinho; Henrique Pott Junior

    2009-01-01

    A aterosclerose em artérias renais é um importante fator desencadeante de tromboses com subsequente comprometimento da função e da viabilidade renal. A oclusão aguda das artérias renais por trombo ou êmbolo é causa incomum e potencialmente reversível de falência renal. Todavia, a duração e o grau de oclusão arterial compatível com a manutenção da viabilidade do parênquima renal ainda não estão bem estabelecidos, razão pela qual o diagnóstico precoce e a intervenção são importantes. O objetivo...

  20. Role of the Rostral Ventrolateral Medulla in the Arterial Hypertension in Chronic Renal Failure

    Science.gov (United States)

    Dugaich, Adriana P. Castilho; Oliveira-Sales, Elizabeth B.; Abreu, Nayda P.; Boim, Mirian A.; Bergamaschi, Cássia T.; Campos, Ruy R.

    2010-01-01

    Sympathetic activation in chronic renal failure (CRF) is a major mechanism leading to the progression of renal disease and hypertension. In the present study, we tested the hypothesis that in CRF increased reactive oxygen species (ROS) production in the RVLM mediated by enhanced circulating Angiotensin II (Ang II) is an important mechanism leading to hypertension in CRF. In CRF rats we found an increase in the abundance of p47phox and gp91phox mRNA within the RVLM associated with a reduction of Ang II type 1 receptors (AT1) mRNA in the brainstem compared to controls (C). Tempol but not candesartan into the RVLM decreased MAP in CRF but not in C rats. GABA into the RVLM decreased MAP in CRF (63 ± 8 mmHg) more intensely than in C (33 ± 3 mmHg). The results suggest that increased oxidative stress within the RVLM has an important participation to maintain hypertension in CRF rats apparently independently of AT1 Ang II receptors. PMID:21253520

  1. Fluvastatin prevents renal injury and expression of lactin-like exidized low-density lipoprotein receptor-1 in rabbits with hypercholesterolemia

    Institute of Scientific and Technical Information of China (English)

    YU Yong-hui; WANG Yi; DONG Bo; SUN Shu-zhen; CHEN Yao; MENG Xiao-hui; LIU Zhong-zhi

    2005-01-01

    renal artery and markedly decreased the enhanced LOX-1 expression in the endothelium and neointima of the renal artery in rabbits.Conclusions Fuvastatin treatment could prevent the development of renal injury in patients with HC and early atherosclerosis (AS). This beneficial effect might be mediated by its pleiotropic effects including a decrease in total cholesterol exposure level and prevention of LOX-1 expression in atherosclerotic arteries.

  2. How much can be inferred from the left main coronary artery?

    Institute of Scientific and Technical Information of China (English)

    Esteban Escolar; Nell J. Weissman

    2004-01-01

    @@ Atherosclerotic diseases is a diffuse process that involves the coronaries, carotids, renals and all other peripheral arteries owing to the systemic nature of atherosclerotic pathophysiology. This systemic precipitants that promote aggressive atherogenesis have been confirmed in multiple studies showing a relationship between atherosclerotic disease in one vascular bed with disease in another. However, the strength of this relationship varies from patient to patient. Thus, the practical utility of the diffuse nature of atheresclerosis is questionable. Ge and colleagues have proposed the use of left main (LM)coronary artery disease as a potential marker for left anterior descending (lAD) atherosclerotic disease. At first thought, this seems useless since the evaluation of the LM (by angiography or IVUS) can just as easily be performed in the LAD so why bother searching for such a surrogate? However, newer (non-invasive) imaging modalifies are making great gains and will be able to reliably image the LM sooner than the LAD (especially the distal LAD) so such a surrogate could have practical applications.

  3. Carotid artery calcification at the initiation of hemodialysis is a risk factor for cardiovascular events in patients with end-stage renal disease: a cohort study

    OpenAIRE

    Ikeda Hirofumi; Nishida Kanako; Sumida Yoko; Okada Yasushi; Nagata Masaharu; Ura Yoriko; Nakayama Masaru; Kaizu Yoshiki

    2011-01-01

    Abstract Background Vascular calcification has been recognized as a risk factor for cardiovascular (CV) events in patients with end-stage renal disease (ESRD). However, the association of carotid artery calcification (CAAC) with CV events remains unknown. The aim of this study was to elucidate whether CAAC is associated with composite CV events in ESRD patients. Methods One-hundred thirty-three patients who had been started on hemodialysis between 2004 and 2008 were included in this retrospec...

  4. C-reactive protein, renal function, and cardiovascular outcome in patients with symptomatic peripheral artery disease and preserved left ventricular systolic function

    OpenAIRE

    Vrsalović, Mislav; Vučur, Ksenija; Car, Boris; Krčmar, Tomislav; Vrsalović Presečki, Ana

    2015-01-01

    Aim To investigate the prognostic role of C-reactive protein (CRP) and renal function for the occurrence of major adverse cardiovascular events (MACE) in patients with symptomatic peripheral artery disease (PAD) and preserved left ventricular ejection fraction (LVEF). Methods The occurrence of MACE, defined as composite endpoint of acute myocardial infarction, urgent coronary revascularization, stroke, and death was assessed in 319 consecutive PAD patients admitted to the University Hospital ...

  5. Detection of renal artery stenosis in hypertensive patients using the scintillation camera and small computer

    International Nuclear Information System (INIS)

    A new technique has been developed to measure relative renal blood flow between the two kidneys. Following intravenous injection of sup(99m)Tc-gluconate, first pass radioactivity versus time curves (2-4 points per second) are obtained over each kidney using the scintillation camera interfaced to a dedicated digital computer. Data analysis, employing fundamental principles of dye-dilution theory, is performed only on the first five seconds of the curves following appearance of radioactivity in the kidneys. The rapidity and ease with which the data can be collected and analysed offer significant advantages over other techniques which use 131I-hippurate and require large off-site digital computers for analysis. (author)

  6. Cerebral Small Vessel Disease and Risk of Death, Ischemic Stroke, and Cardiac Complications in Patients With Atherosclerotic Disease The Second Manifestations of ARTerial disease-Magnetic Resonance (SMART-MR) Study

    NARCIS (Netherlands)

    M.M.A. Conijn; R.P. Kloppenborg; A. Algra; W.P.T.M. Mali; L.J. Kappelle; K.L. Vincken; Y. van der Graaf; M.I. Geerlings

    2011-01-01

    Background and Purpose-Cerebral small vessel disease may be related to vascular and nonvascular pathology. We assessed whether lacunar infarcts and white matter lesions on MRI increased the risk of vascular and nonvascular death and future vascular events in patients with atherosclerotic disease. Me

  7. Melatonin potentiates the vasoconstrictive effect of noradrenaline in renal artery from newborn hooded seals (Cystophora cristata) and harp seals (Phoca groenlandica).

    Science.gov (United States)

    Aarseth, J J; Nordøy, E S; Stokkan, K A

    2001-08-01

    Isometric tension was recorded by force displacement transducers in ring segments of the inferior branch of the renal artery from newborn hooded seals (Cystophora cristata, n=6), harp seals (Phoca groenlandica, n=3) and domestic pigs (Sus scrofa f. domestica, n=5). Arterial segments were mounted in heated organ baths and exposed to graded concentrations of noradrenaline (NA) and adrenaline (A), alone or together with melatonin. The melatonin concentration in the bath was similar to the plasma concentration normally found in each experimental animal. Melatonin alone did not affect the tension in any of the species, but melatonin potentiated the contraction induced by NA in hooded and harp seal arteries to a maximum of about 25% above the resting, pre-stretch level. The selective melatonin receptor antagonist luzindole reduced this potentiation by 80%. Species-specific concentrations of melatonin did not potentiate the NA-effect in the domestic pig or the A-induced contraction in any of the species. The results indicate that melatonin specifically increases the NA-sensitivity of smooth muscles in renal arteries from newborn seals. It is presumed that similar effects may operate in foetal and maternal seals and may influence their circulation during maternal diving. PMID:11585261

  8. Trombose da artéria renal e síndrome do anticorpo antifosfolípide: um relato de caso Renal arterial thrombosis and the antiphospholipid antibody syndrome: a case report

    Directory of Open Access Journals (Sweden)

    Célia S. Macedo

    2001-12-01

    Full Text Available OBJETIVO: descrever um caso clínico raro na infância, com achados clínicos da síndrome do anticorpo antifosfolípide. DESCRIÇÃO: criança, sexo masculino, com 2 anos e 6 meses de idade, com insuficiência renal, trombose da artéria renal e diagnóstico de síndrome do anticorpo antifosfolípide, foi internada com dor abdominal, palidez, letargia e anúria há 36 horas. Ao exame físico, apresentava-se desnutrida, com hipertensão arterial severa, edema moderado e dor em hipocôndrio. Os achados laboratoriais incluíram: uréia=112mg/dl; creatinina plasmática=4,5 mg/dl; pH sangüíneo=7,47; bicarbonato sangüíneo=12,8 mmol/L; K=7,2 mEq/L. A diálise peritoneal foi iniciada e mantida por 11 dias. Após 7 semanas de evolução, o paciente ainda necessitava de droga anti-hipertensiva e a função renal estava anormal. A biópsia renal revelou infarto renal anêmico; ultra-sonografia renal com doppler, fluxo sangüíneo renal ausente no lado direito, e a arteriografia mostrou oclusão total da artéria renal direita. A pesquisa de doenças do colágeno foi negativa. Foi realizada nefrectomia à direita obtendo-se normalização da pressão arterial. Aos 5 anos e 8 meses, foi novamente hospitalizada com quadro de crises de ausência e dores abdominais e precordiais. A dosagem do anticorpo anticardiolipina foi positiva. Atualmente aos 7 anos, está em seguimento ambulatorial, assintomática e com dosagens negativas do anticorpo anticardiolipina. COMENTÁRIOS: as observações deste caso mostram que crianças com quadro de trombose arterial, mesmo na ausência de doenças do colágeno, devem ser investigadas para uma possível associação com a síndrome do anticorpo antifosfolípide.OBJECTIVE: to describe an unusual case with clinical features of the antiphospholipid syndrome. DESCRIPTION: white child, two years and six months old, with renal failure, renal arterial thrombosis, and diagnosis of antiphospholipid syndrome was hospitalized with

  9. Renal Arteriovenous Fistula with Rapid Blood Flow Successfully Treated by Transcatheter Arterial Embolization: Application of Interlocking Detachable Coil as Coil Anchor

    International Nuclear Information System (INIS)

    A 70-year-old woman presented to our outpatient clinic with a large idiopathic renal arteriovenous fistula (AVF). Transcatheter arterial embolization (TAE) using interlocking detachable coils (IDC) as an anchor was planned. However, because of markedly rapid blood flow and excessive coil flexibility, detaching an IDC carried a high risk of migration. Therefore, we first coiled multiple loops of a microcatheter and then loaded it with an IDC. In this way, the coil was well fitted to the arterial wall and could be detached by withdrawing the microcatheter during balloon occlusion ('pre-framing technique'). Complete occlusion of the afferent artery was achieved by additional coiling and absolute ethanol. This technique contributed to a safe embolization of a high-flow AVF, avoiding migration of the IDC

  10. Value of detection of atherosclerotic lesions using autologous labelled platelets

    Energy Technology Data Exchange (ETDEWEB)

    Sinzinger, H.; Silberbauer, K.; Fitscha, P.; Kaliman, J. (Vienna Univ. (Austria). 2. Medizinische Klinik; Vienna Univ. (Austria). Kardiologische Abt.; Allgem. Poliklinik, Vienna (Austria). 2. Medizinische Abteilung)

    1982-01-01

    In 44 patients with clinical signs of carotid artery stenosis a positive Doppler-ultrasound was obtained. In all patients the lesions were confirmed by angiography. In the patients labelling of autologous platelets with 111 Indium-oxine-sulphate was done in order to calculate the platelet half-life. In addition we tried to visualize the verified atherosclerotic lesions under a gamma-camera. In all patients the platelet half-life was significantly shortened in comparison to the controls. In none of the patients studied a visualization of the angiographically verified atherosclerotic lesions could be obtained. These findings point out, that only in recently developed and very severe atherosclerotic lesions the number of platelets deposed on the vascular surface is enough to allow gamma-camera imaging.

  11. Coronary perivascular adipose tissue characteristics are related to atherosclerotic plaque size and composition : A post-mortem study

    NARCIS (Netherlands)

    Verhagen, Sandra N.; Vink, Aryan; van der Graaf, Yolanda; Visseren, Frank L. J.

    2012-01-01

    Background: Perivascular adipose tissue (pvAT) may influence atherosclerotic plaque formation. We aim to determine the association between the local amount and inflammatory properties of pvAT and the size and composition of atherosclerotic plaque in the left anterior descending artery (LAD). Methods

  12. Optimal Blood Suppression inversion time based on breathing rates and heart rates to improve renal artery visibility in spatial labeling with multiple inversion pulses: A preliminary study

    Energy Technology Data Exchange (ETDEWEB)

    Pei, Yi Gang; Li, Fang; Long, Xue Ying; Liu, Hui; Wang, Xiao Yi; Liu, Jin Kang; Li, Wen Zheng [Dept. of Radiology, Xiangya Hospital, Central South University, Changsha (China); Shen, Hao [GE Healthcare, Waukesha (United States)

    2016-02-15

    To determine whether an optimal blood suppression inversion time (BSP TI) can boost arterial visibility and whether the optimal BSP TI is related to breathing rate (BR) and heart rate (HR) for hypertension subjects in spatial labeling with multiple inversion pulses (SLEEK). This prospective study included 10 volunteers and 93 consecutive hypertension patients who had undergone SLEEK at 1.5T MRI system. Firstly, suitable BSP TIs for displaying clearly renal artery were determined in 10 volunteers. Secondly, non-contrast enhanced magnetic resonance angiography with the suitable BSP TIs were performed on those hypertension patients. Then, renal artery was evaluated and an optimal BSP TI to increase arterial visibility was determined for each patient. Patients' BRs and HRs were recorded and their relationships with the optimal BSP TI were analyzed. The optimal BSP TI was negatively correlated with BR (r1 = -0.536, P1 < 0.001; and r2 = -0.535, P2 < 0.001) and HR (r1 = -0.432, P1 = 0.001; and r2 = -0.419, P2 = 0.001) for 2 readers (κ = 0.93). For improving renal arterial visibility, BSP TI = 800 ms could be applied as the optimal BSP TI when the 95% confidence interval were 17-19/min (BR1) and 74-82 bpm (HR1) for reader#1 and 17-19/min (BR2) and 74-83 bpm (HR2) for reader#2; BSP TI = 1100 ms while 14-15/min (BR1, 2) and 71-76 bpm (HR1, 2) for both readers; and BSP TI = 1400 ms when 13-16/min (BR1) and 63-68 bpm (HR1) for reader#1 and 14-15/min (BR2) and 64-70 bpm (HR2) for reader#2. In SLEEK, BSP TI is affected by patients' BRs and HRs. Adopting the optimal BSP TI based on BR and HR can improve the renal arterial visibility and consequently the working efficiency.

  13. Renal blood flow using arterial spin labelling MRI and calculated filtration fraction in healthy adult kidney donors pre-nephrectomy and post-nephrectomy

    Energy Technology Data Exchange (ETDEWEB)

    Cutajar, Marica; Clark, Christopher A.; Gordon, Isky [University College London, Imaging and Biophysics Unit, Institute of Child Health, London (United Kingdom); Hilton, Rachel; Olsburgh, Jonathon [Renal Unit, Guy' s and St Thomas' NHS Foundation Trust, London (United Kingdom); Marks, Stephen D. [Great Ormond Street Hospital for Children NHS Foundation Trust, Department of Paediatric Nephrology, London (United Kingdom); Thomas, David L. [University College London, Department of Brain Repair and Rehabilitation, Institute of Neurology, London (United Kingdom); Banks, Tina [Great Ormond Street Hospital for Children NHS Foundation Trust, Department of Radiology, London (United Kingdom)

    2015-08-15

    Renal plasma flow (RPF) (derived from renal blood flow, RBF) and glomerular filtration rate (GFR) allow the determination of the filtration fraction (FF), which may have a role as a non-invasive renal biomarker. This is a hypothesis-generating pilot study assessing the effect of nephrectomy on renal function in healthy kidney donors. Eight living kidney donors underwent arterial spin labelling (ASL) magnetic resonance imaging (MRI) and GFR measurement prior to and 1 year after nephrectomy. Chromium-51 labelled ethylenediamine tetraacetic acid ({sup 51}Cr-EDTA) with multi-blood sampling was undertaken and GFR calculated. The RBF and GFR obtained were used to calculate FF. All donors showed an increase in single kidney GFR of 24 - 75 %, and all but two showed an increase in FF (-7 to +52 %) after nephrectomy. The increase in RBF, and hence RPF, post-nephrectomy was not as great as the increase in GFR in seven out of eight donors. As with any pilot study, the small number of donors and their relatively narrow age range are potential limiting factors. The ability to measure RBF, and hence RPF, non-invasively, coupled with GFR measurement, allows calculation of FF, a biomarker that might provide a sensitive indicator of loss of renal reserve in potential donors. (orig.)

  14. Renal blood flow using arterial spin labelling MRI and calculated filtration fraction in healthy adult kidney donors pre-nephrectomy and post-nephrectomy

    International Nuclear Information System (INIS)

    Renal plasma flow (RPF) (derived from renal blood flow, RBF) and glomerular filtration rate (GFR) allow the determination of the filtration fraction (FF), which may have a role as a non-invasive renal biomarker. This is a hypothesis-generating pilot study assessing the effect of nephrectomy on renal function in healthy kidney donors. Eight living kidney donors underwent arterial spin labelling (ASL) magnetic resonance imaging (MRI) and GFR measurement prior to and 1 year after nephrectomy. Chromium-51 labelled ethylenediamine tetraacetic acid (51Cr-EDTA) with multi-blood sampling was undertaken and GFR calculated. The RBF and GFR obtained were used to calculate FF. All donors showed an increase in single kidney GFR of 24 - 75 %, and all but two showed an increase in FF (-7 to +52 %) after nephrectomy. The increase in RBF, and hence RPF, post-nephrectomy was not as great as the increase in GFR in seven out of eight donors. As with any pilot study, the small number of donors and their relatively narrow age range are potential limiting factors. The ability to measure RBF, and hence RPF, non-invasively, coupled with GFR measurement, allows calculation of FF, a biomarker that might provide a sensitive indicator of loss of renal reserve in potential donors. (orig.)

  15. The Role of Partial Nephrectomy without Arterial Embolization in Giant Renal Angiomyolipoma

    Directory of Open Access Journals (Sweden)

    Enis Rauf Coskuner

    2012-01-01

    Full Text Available Angiomyolipoma is a benign neoplasm composed of varying admixtures of blood vessels, smooth muscle cells, and adipose tissue. Because of an increased risk of spontaneous haemorrhage, surgical approach is needed greater than 4–8 cm size. We here report our partial nephrectomy experience in the 24 cm size giant angiomyolipoma. 26-year-old woman referred to our clinic with a 24 cm size angiomyolipoma in her lower pole of right kidney. The inferior vena cava was deviated to the left by the mass. All the blood tests were normal and we offered her the choices of partial nephrectomy or nephrectomy. Right subcostal approach was used. The patient underwent resection of the mass with a safety region of 1 cm. Frozen section evaluation was consistent with angiomyolipoma and free for surgical margin. Warm ischemia time was 35 min. and intraoperative bleeding volume was 200 cc. Postoperative 2nd day the drain was taken and hospital stay was 4 days. In literature we observed very rare angiomyolipoma cases with such a large dimension treated by partial nephrectomy without arterial embolization. If technically suitable partial nephrectomy is the main chioce in this kind of benign lesions in young patients.

  16. The Role of Partial Nephrectomy without Arterial Embolization in Giant Renal Angiomyolipoma.

    Science.gov (United States)

    Coskuner, Enis Rauf; Ozkan, Burak; Yalcin, Veli

    2012-01-01

    Angiomyolipoma is a benign neoplasm composed of varying admixtures of blood vessels, smooth muscle cells, and adipose tissue. Because of an increased risk of spontaneous haemorrhage, surgical approach is needed greater than 4-8 cm size. We here report our partial nephrectomy experience in the 24 cm size giant angiomyolipoma. 26-year-old woman referred to our clinic with a 24 cm size angiomyolipoma in her lower pole of right kidney. The inferior vena cava was deviated to the left by the mass. All the blood tests were normal and we offered her the choices of partial nephrectomy or nephrectomy. Right subcostal approach was used. The patient underwent resection of the mass with a safety region of 1 cm. Frozen section evaluation was consistent with angiomyolipoma and free for surgical margin. Warm ischemia time was 35 min. and intraoperative bleeding volume was 200 cc. Postoperative 2nd day the drain was taken and hospital stay was 4 days. In literature we observed very rare angiomyolipoma cases with such a large dimension treated by partial nephrectomy without arterial embolization. If technically suitable partial nephrectomy is the main chioce in this kind of benign lesions in young patients. PMID:22536263

  17. Guidelines for the optimization of microsurgery in atherosclerotic patients.

    Science.gov (United States)

    Chen, Hung-Chi; Coskunfirat, O Koray; Ozkan, Omer; Mardini, Samir; Cigna, Emanuele; Salgado, Christopher J; Spanio, Stefano

    2006-01-01

    We review the pathogenesis of atherosclerosis and the issues that must be taken into consideration when performing microsurgery in atherosclerotic patients. Atherosclerosis is a systemic disease, and may affect the success of microsurgery. Atherosclerotic patients have a tendency toward thrombosis, because the nature of the arteries is changed. Such patients are usually old and have additional medical problems. To increase the success rate of microsurgery in atherosclerotic patients, special precautions should be considered. Patients must be evaluated properly for the suitability of microsurgery. The microsurgical technique requires a meticulous approach, and various technical tricks can be used to avoid thrombosis. Recipient-vessel selection, anastomotic technique, and the use of vein grafts are all important issues. Prophylactic anticoagulation is recommended in severely atherosclerotic patients. Close monitoring of the patient and flap is necessary after the operation, as with routine microvascular free-tissue transfers. We conclude that atherosclerosis is not a contraindication for microsurgery. If the microsurgeon knows how to deal with the difficulties in atherosclerotic patients, microsurgery can be performed safely. PMID:16761266

  18. Atherosclerotic Vessel Changes in Sarcoidosis.

    Science.gov (United States)

    Tuleta, I; Pingel, S; Biener, L; Pizarro, C; Hammerstingl, C; Öztürk, C; Schahab, N; Grohé, C; Nickenig, G; Schaefer, C; Skowasch, D

    2016-01-01

    Sarcoidosis is a systemic granulomatous disease. Atherosclerosis is a chronic inflammatory vessel disease. The aim of our present study was to investigate whether sarcoidosis could be associated with increased risk of atherosclerotic vessel changes. Angiological analysis and blood tests were performed in 71 sarcoidosis patients and 12 matched controls in this prospective cross-sectional study. Specifically, angiological measurements comprised ankle brachial index (ABI), central pulse wave velocity (cPWV), pulse wave index (PWI), and duplex sonography of central and peripheral arteries. Sarcoidosis activity markers (angiotensin converting enzyme, soluble interleukin-2 receptor) and cardiovascular risk parameters such as cholesterol, lipoprotein(a), C-reactive protein, interleukin 6, fibrinogen, d-dimer, and blood count were analyzed in blood. We found no relevant differences in ABI, cPWV, and plaque burden between the sarcoidosis and control groups (1.10 ± 0.02 vs. 1.10 ± 0.02, 6.7 ± 0.5 vs. 6.1 ± 1.2, 53.7 % vs. 54.5 %, respectively). However, PWI was significantly higher in sarcoidosis patients (146.2 ± 6.8) compared with controls (104.9 ± 8.8), irrespectively of the activity of sarcoidosis and immunosuppressive medication. Except for increased lipoprotein(a) and d-dimer in sarcoidosis, the remaining cardiovascular markers were similar in both groups. We conclude that sarcoidosis is associated with increased pulse wave index, which may indicate an early stage of atherosclerosis. PMID:26820732

  19. Inhibiting extracellular matrix metalloproteinase inducer maybe beneficial for diminishing the atherosclerotic plaque instability

    Directory of Open Access Journals (Sweden)

    Xie S

    2009-01-01

    Full Text Available Atherosclerotic plaque rupture and local thrombosis activation in the artery cause acute serious incidents such as acute coronary syndrome and stroke. The exact mechanism of plaque rupture remains unclear but excessive degradation of the extracellular matrix scaffold by matrix-degrading metalloproteinases (MMPs has been implicated as one of the major molecular mechanisms in this process. Convincing evidence is available to prove that extracellular matrix metalloproteinase inducer (EMMPRIN induces MMP expression and is involved in the inflammatory responses in the artery wall. The inflammation and MMPs have been shown to play a critical role for atherosclerotic lesion development and progression. More recent data showed that increased EMMPRIN expression was associated with vulnerable atherosclerotic lesions. Therefore, we speculate that EMMPRIN may be pivotal for atherosclerotic plaque instability, and hence inhibition of EMMPRIN expression could be a promising approach for the prevention or treatment of atheroma instability.

  20. Ineffectiveness of dipyridamole SPECT thallium imaging as a screening technique for coronary artery disease in patients with end-stage renal failure

    International Nuclear Information System (INIS)

    The efficacy of dipyridamole single photon emission computed tomography (SPECT) thallium as a screening test for coronary artery disease (CAD), was studied in 45 patients with end-stage renal failure undergoing evaluation for renal transplantation. Coronary arteriography, dipyridamole SPECT thallium imaging and clinical follow-up were performed in all patients. Nineteen patients (42%) had an obstruction of 50% or more in at least one coronary artery. Fourteen patients had a positive thallium scan, but 7 of these were false-positives (sensitivity 37%, specificity 73%). The sensitivity was considerably lower than that quoted for non-ESRF patients in the literature, and significantly lower than a control group of 19 patients without ESRF having comparable severity and distribution of CAD. Five of the 6 patients who died of cardiac causes over a mean follow-up period of 25 months had normal thallium imaging, but all had significant coronary artery disease at cardiac catheterization. Dipyridamole SPECT thallium imaging has not proved a useful screening test for angiographically significant CAD, and does not predict cardiac prognosis in this population

  1. Plaque Rupture and Thrombosis: the Value of the Atherosclerotic Rabbit Model in Defining the Mechanism.

    Science.gov (United States)

    Abela, Oliver G; Ahsan, Chowdhury H; Alreefi, Fadi; Salehi, Negar; Baig, Imran; Janoudi, Abed; Abela, George S

    2016-06-01

    Persistent inflammation and mechanical injury associated with cholesterol crystal accretion within atherosclerotic plaques typically precedes plaque disruption (rupture and/or erosion) and thrombosis-often the terminal events of atherosclerotic cardiovascular disease. To elucidate the mechanisms of these events, the atherosclerotic rabbit model provides a unique and powerful tool that facilitates studies of atherogenesis starting with plaque buildup to eventual disruption. Examination of human coronary arteries obtained from patients who died with myocardial infarction demonstrates evidence of cholesterol crystals perforating the plaque cap and intimal surface of the arterial wall that can lead to rupture. These observations were made possible by omitting ethanol, an avid lipid solvent, from the tissue processing steps. Importantly, the atherosclerotic rabbit model exhibits a similar pathology of cholesterol crystals perforating the intimal surface as seen in ruptured human plaques. Local and systemic inflammatory responses in the model are also similar to those observed in humans. The strong parallel between the rabbit and human pathology validates the atherosclerotic rabbit model as a predictor of human pathophysiology of atherosclerosis. Thus, the atherosclerotic rabbit model can be used with confidence to evaluate diagnostic imaging and efficacy of novel anti-atherosclerotic therapy. PMID:27091328

  2. Atherosclerotic plaque component segmentation in combined carotid MRI and CTA data incorporating class label uncertainty

    OpenAIRE

    Engelen, Arna; Niessen, Wiro; Klein, Stefan; Groen, Harald; Verhagen, Hence; Wentzel, Jolanda; van der Lugt, Aad; de Bruijne, Marleen

    2014-01-01

    textabstractAtherosclerotic plaque composition can indicate plaque vulnerability. We segment atherosclerotic plaque components from the carotid artery on a combination of in vivo MRI and CT-angiography (CTA) data using supervised voxelwise classification. In contrast to previous studies the ground truth for training is directly obtained from 3D registration with histology for fibrous and lipid-rich necrotic tissue, and with μCT for calcification. This registration does, however, not provide a...

  3. Atherosclerotic Plaque Component Segmentation in Combined Carotid MRI and CTA Data Incorporating Class Label Uncertainty

    OpenAIRE

    van Engelen, A.; Niessen, W.J.; Klein, S.; Groen, H. C.; Verhagen, H. J. M.; Wentzel, J.J.; van der Lugt, A.; De Bruijne, M.

    2014-01-01

    Atherosclerotic plaque composition can indicate plaque vulnerability. We segment atherosclerotic plaque components from the carotid artery on a combination of in vivo MRI and CT-angiography (CTA) data using supervised voxelwise classification. In contrast to previous studies the ground truth for training is directly obtained from 3D registration with histology for fibrous and lipid-rich necrotic tissue, and with CT for calcification. This registration does, however, not provide accurate voxel...

  4. Atherosclerotic plaque component segmentation in combined carotid MRI and CTA data incorporating class label uncertainty

    OpenAIRE

    2014-01-01

    Atherosclerotic plaque composition can indicate plaque vulnerability. We segment atherosclerotic plaque components from the carotid artery on a combination of in vivo MRI and CT-angiography (CTA) data using supervised voxelwise classification. In contrast to previous studies the ground truth for training is directly obtained from 3D registration with histology for fibrous and lipid-rich necrotic tissue, and with [Formula: see text]CT for calcification. This registration does, however, not pro...

  5. In-vivo Attenuation and Equivalent Scatterer size parameters for Atherosclerotic Carotid Plaque: Preliminary Results

    OpenAIRE

    Shi, Hairong; Varghese, Tomy; Mitchell, Carol C; McCormick, Matthew; Dempsey, Robert J; Kliewer, Mark A.

    2009-01-01

    We have previously reported on the equivalent scatterer size, attenuation coefficient, and axial strain properties of atherosclerotic plaque ex-vivo. Since plaque structure and composition may be damaged during a carotid endarterectomy procedure, characterization of in-vivo properties of atherosclerotic plaque is essential. The relatively shallow depth of the carotid artery and plaque enables non-invasive evaluation of carotid plaque utilizing high frequency linear array transducers. We inves...

  6. Hipertensión arterial como factor predictivo en pacientes con cáncer renal tratados con antiangiogénicos Hypertension as predictive factor in renal cell cancer treated with antiangiogenic therapy

    OpenAIRE

    Luciana Gennari; Javier Belinky; Claudio Graziano; Gustavo Jankilevich

    2011-01-01

    El conocimiento de las diversas vías de oncogénesis ha llevado al desarrollo en los últimos cinco años de nuevas terapias para el tratamiento del cáncer renal avanzado, las que poseen como blanco al factor derivado del endotelio vascular (VEGF) y sus receptores (antiangiogénicos) y al blanco mamífero de la rapamicina (mTOR). Los antiangiogénicos constituyen un grupo de moléculas activas con un espectro de toxicidad peculiar que comprende el desarrollo de hipertensión arterial, disfunción tiro...

  7. Sodio intercambiable y sistema renina en la insuficiencia renal crónica y en la hipertensión arterial

    OpenAIRE

    Botey Puig, Albert

    1980-01-01

    [spa] El objetivo de esta tesis doctoral es aportar nuevos datos sobre el grado de participación del sodio y el sistema renina-angiotensina en los diferentes tipos de hipertensión. En ella se valora el equilibrio sódico del organismo, el eje renina-angiotensina-aldosterona, la relación entre ambos y de cada uno de ellos respecto a la tensión arterial, en la insuficiencia renal crónica y en la hipertensión tanto esencial como secundaria. Para ello se estudia el sodio intercambiable y el volume...

  8. Manual and automated intima-media thickness and diameter measurements of the common carotid artery in patients with renal failure disease.

    Science.gov (United States)

    Loizou, Christos P; Kasparis, Takis; Lazarou, Theodoros; Pattichis, Constandinos S; Pantziaris, Marios

    2014-10-01

    The objective of this study was to investigate differences in intima-media thickness (IMT) and diameter (D) measurements of the common carotid artery (CCA) in ultrasound imaging in normal subjects and renal failure disease (RFD) patients. Manual measurements by two experts and automated segmentation measurements (based on snakes and active contour models (ACM)) were carried out on 73 normal subjects, and 80 RFD patients. Statistical analysis was carried out using the Wilcoxon rank-sum test at psegmentation was slightly more accurate than segmentation based on snakes. Further work is needed to validate these findings on a larger group of subjects. PMID:25173810

  9. Hipertensión arterial como factor predictivo en pacientes con cáncer renal tratados con antiangiogénicos

    OpenAIRE

    2011-01-01

    El conocimiento de las diversas vías de oncogénesis ha llevado al desarrollo en los últimos cinco años de nuevas terapias para el tratamiento del cáncer renal avanzado, las que poseen como blanco al factor derivado del endotelio vascular (VEGF) y sus receptores (antiangiogénicos) y al blanco mamífero de la rapamicina (mTOR). Los antiangiogénicos constituyen un grupo de moléculas activas con un espectro de toxicidad peculiar que comprende el desarrollo de hipertensión arterial, disfunción tiro...

  10. A gene-centric study of common carotid artery remodelling

    NARCIS (Netherlands)

    Harrison, Seamus C.; Zabaneh, Delilah; Asselbergs, Folkert W.; Drenos, Fotios; Jones, Gregory T.; Shah, Sonia; Gertow, Karl; Sennblad, Bengt; Strawbridge, Rona J.; Gigante, Bruna; Holewijn, Suzanne; De Graaf, Jacqueline; Vermeulen, Sita; Folkersen, Lasse; van Rij, Andre M.; Baldassarre, Damiano; Veglia, Fabrizio; Talmud, Philippa J.; Deanfield, John E.; Agu, Obi; Kivimaki, Mika; Kumari, Meena; Bown, Matthew J.; Nyyssonen, Kristiina; Rauramaa, Rainer; Smit, Andries J.; Franco-Cereceda, Anders; Giral, Philippe; Mannarino, Elmo; Silveira, Angela; Syvanen, Ann-Christine; de Borst, Gert J.; van der Graaf, Yolanda; de Faire, Ulf; Baas, Annette F.; Blankensteijn, Jan D.; Wareham, Nicholas J.; Fowkes, Gerry; Tzoulaki, Ionna; Price, Jacqueline F.; Tremoli, Elena; Hingorani, Aroon D.; Eriksson, Per; Hamsten, Anders; Humphries, Steve E.

    2013-01-01

    Background: Expansive remodelling is the process of compensatory arterial enlargement in response to atherosclerotic stimuli. The genetic determinants of this process are poorly characterized. Methods: Genetic association analyses of inter-adventitial common carotid artery diameter (ICCAD) in the IM

  11. Ophthalmic masquerades of the atherosclerotic carotids

    Directory of Open Access Journals (Sweden)

    Anupriya Arthur

    2014-01-01

    Full Text Available Patients with carotid atherosclerosis can present with ophthalmic symptoms. These symptoms and signs can be due to retinal emboli, hypoperfusion of the retina and choroid, opening up of collateral channels, or chronic hypoperfusion of the globe (ocular ischemic syndrome. These pathological mechanisms can produce many interesting signs and a careful history can bring out important past symptoms pointing toward the carotid as the source of the patient′s presenting symptom. Such patients are at high risk for an ischemic stroke, especially in the subsequent few days following their first acute symptom. It is important for clinicians to be familiar with these ophthalmic symptoms and signs caused by carotid atherosclerosis for making an early diagnosis and to take appropriate measures to prevent a stroke. This review elaborates the clinical features, importance, and implications of various ophthalmic symptoms and signs resulting from atherosclerotic carotid artery disease.

  12. Prevalence of coronary artery disease in Japanese patients with cerebral infarction. Impact of metabolic syndrome and intracranial large artery atherosclerosis

    International Nuclear Information System (INIS)

    Patients with cerebral infarction have a high prevalence of asymptomatic coronary artery disease (CAD) and other vascular diseases, but there is a lack of such data for Japanese patients, so the present study investigated the prevalence of cardiovascular disease (CVD) in Japanese patients and determined the predictors of CAD. The study group comprised 104 patients with cerebral infarction who had no history of CVD. All patients underwent coronary computed tomographic angiography, and systematic evaluation was done on the basis of the presence of other vascular diseases, CVD risk markers, and the degree of atherosclerosis. Of the total, 39 patients (37.5%) had CAD, 9 (8.7%) had carotid artery stenosis, 9 (8.7%) had peripheral artery disease of the lower limbs, and 3 (2.9%) had atherosclerotic renal artery stenosis. Multiple regression analysis showed that the presence of CAD was independently associated with metabolic syndrome (odds ratio (OR) 5.008, 95% confidence interval (CI) 1.538-16.309; p<0.01) and intracranial large artery atherosclerosis (OR 4.979, 95% CI 1.633-15.183; p<0.01). Japanese patients with cerebral infarction have a high prevalence of CVD, especially asymptomatic CAD. Both metabolic syndrome and intracranial large artery atherosclerosis may be potential predictors for identifying patients with cerebral infarction who are at the highest risk of asymptomatic CAD. (author)

  13. HIPERTENSÃO ARTERIAL NA DOENÇA RENAL CRÔNICA EM PEQUENOS ANIMAIS – REVISÃO DA LITERATURA

    Directory of Open Access Journals (Sweden)

    André Luiz Baptista Glvão

    2010-11-01

    Full Text Available A doença renal crônica (DRC é caracterizada por lesões estruturais irreversíveis, que podem evoluir progressivamente para uremia e falência renal. Após a instalação inicial da lesão renal, ocorremmudanças estruturais e funcionais adaptativas dos néfrons remanescentes, na tentativa de manter a homeostase, principalmente quanto à regulação do volume e da composição do fluido corporal extracelular. A hipertensão sistêmica é uma das complicações cardiovasculares mais frequentemente reconhecidas da DRC em cães e gatos. Os órgãos mais afetados pela hipertensão são os que estão envolvidos na regulação do fluxo sanguíneo (coração e os que contêm extensas redes arteriolares ou capilares (olhos, cérebro, rins. Nos rins a hipertensão esta associada a presença de proteinúria e progressão de dano glomerular. Desse modo, apresentamos esta revisão de literatura com objetivo de descrever as alterações sistêmicas relacionadas com o envolvimento da doença renal crônica com a hipertensão arterial, como também sua patofisiologia, recursos em diagnóstico, condutas e opções terapêuticas a serem adotadas com o paciente.Chronic kidney disease (CKD is characterized by irreversible structural lesions can developprogressively for uremia and chronic renal failure (CRF. After first renal lesion, occur structural and functionalalterations in remaining nephrons, with objective to maintain homeostasis, mainly for the volume and thecomposition fluid extracell. Systemic hypertension is the most important cardiovascular complications in CKDin the dogs and cats. Organs more affected by hypertension are these involved in the regulation sanguine flow(heart and others that contain extensive arteriolares or capillary nets (eyes, brain, kidneys. In the kidneyshypertension is associated with proteinuria presence and progression glomerular damage. This way, the objectivethis literary revision was to describe systemic alterations related

  14. In vivo distribution of recombinant interleukin-2-activated autologous lymphocytes administered by intra-arterial infusion in patients with renal cell carcinoma

    International Nuclear Information System (INIS)

    Recombinant interleukin-2 (RIL 2)-activated autologous peripheral blood lymphocytes (PBL) were infused directly into the renal arteries of 3 patients with renal cell carcinoma, and the in vivo distribution of the infused cells was investigated. In vitro studies to define the optimal culture conditions indicated that maximal lymphokine-activated killer activity was observed at around 10-20 days in culture, as judged by the cytotoxicity against fresh allogenic tumor cells. Maximal expression of the interleukin-2 receptor was also obtained at around 10 days. PBL collected by leukopheresis from each patient were thus cultured for 10 days with RIL 2, labeled with 111In-oxine, and then infused directly into the renal artery of the affected kidney via a catheter. Radioactivity in the infused side of the kidneys increased immediately after the infusion but then gradually decreased. Radioactivity in the lungs also rapidly increased within the first hour but then cleared gradually, whereas that in the liver and spleen tended to increase steadily. Nevertheless, at 48 hours, the infused side of the kidneys retained levels of radioactivity comparable to those seen in the liver and spleen, while the levels seen in the lungs were already close to background levels. The radioactivity in the areas corresponding to tumors remained consistently higher than that in the normal parts of the affected kidneys. The direct comparison of the radioactivity distribution pattern with the macroscopic appearance of surgically resected kidneys indicated that the accumulation of radioactivity was indeed selectively associated with the tumor tissues in the kidneys, except for a case in which the tumor was quite necrotic and hypovascular

  15. Value of Doppler Ultrasound Hemodynamics in the Assessment of Renal Artery Stenosis in Transplanted Kidneys: An Assessment of Patients after Percutaneous Transluminal Angioplasty

    Directory of Open Access Journals (Sweden)

    Huraib Sameer

    2001-01-01

    Full Text Available Doppler ultrasound (USS may allow a non-invasive early diagnosis of transplant renal artery stenosis (TRAS. Adequate Doppler sampling of the transplant renal artery is difficult, time consuming and highly operator dependent. As a result, there has been increased attention focused on the intrarenal vessels and downstream changes that occur secondary to TRAS. We evaluated Doppler USS parameters in nine patients with TRAS confirmed on angiography (significant stenosis defined as > 60% diameter narrowing. Doppler USS correctly identified all the nine stenoses. Mean peak systolic velocity (PSV was 3.6 m/s + 1.09. Mean end-diastolic velocity (EDV was 1.75 m/s + 0.25 with an acceleration time (AT of 0.14 + 0.04 sec and resistivity index (RI of 0.42 + 0.12. Early systolic peak (ESP was lost in all cases. Percutaneous transluminal angioplasty (PTA was successfully done in five patients with significant improvement in Doppler parameters. PSV decreased from 4.04 m/s + 1.35 to 0.76 m/s + 0.42 (p = 0.01. Similarly EDV improved from 1.71 m/s + 0.28 to 0.30 m/s + 0.17 (p = 0.001. AT improved from 0.13 + 0.01 to 0.05 + 0.01 sec (p = 0.001. RI normalized from 0.34 + 0.07 to 0.73 + 0.09 (p = 0.008. ESP was restored in all the patients. In conclusion: our results show that the Doppler USS analysis of segmental arteries is an excellent tool for the diagnosis of TRAS and follow-up of patients post PTA.

  16. Molecular magnetic resonance imaging of atherosclerotic vessel wall disease

    Energy Technology Data Exchange (ETDEWEB)

    Noerenberg, Dominik [Charite - University Medicine Berlin, Department of Radiology, Berlin (Germany); University of Munich - Grosshadern, Department of Clinical Radiology, Munich (Germany); Ebersberger, Hans U. [Heart Center Munich-Bogenhausen, Department of Cardiology and Intensive Care Medicine, Munich (Germany); Diederichs, Gerd; Hamm, Bernd [Charite - University Medicine Berlin, Department of Radiology, Berlin (Germany); Botnar, Rene M. [King' s College London, Division of Imaging Sciences and Biomedical Engineering, London (United Kingdom); Makowski, Marcus R. [Charite - University Medicine Berlin, Department of Radiology, Berlin (Germany); King' s College London, Division of Imaging Sciences and Biomedical Engineering, London (United Kingdom)

    2016-03-15

    Molecular imaging aims to improve the identification and characterization of pathological processes in vivo by visualizing the underlying biological mechanisms. Molecular imaging techniques are increasingly used to assess vascular inflammation, remodeling, cell migration, angioneogenesis and apoptosis. In cardiovascular diseases, molecular magnetic resonance imaging (MRI) offers new insights into the in vivo biology of pathological vessel wall processes of the coronary and carotid arteries and the aorta. This includes detection of early vascular changes preceding plaque development, visualization of unstable plaques and assessment of response to therapy. The current review focuses on recent developments in the field of molecular MRI to characterise different stages of atherosclerotic vessel wall disease. A variety of molecular MR-probes have been developed to improve the non-invasive detection and characterization of atherosclerotic plaques. Specifically targeted molecular probes allow for the visualization of key biological steps in the cascade leading to the development of arterial vessel wall lesions. Early detection of processes which lead to the development of atherosclerosis and the identification of vulnerable atherosclerotic plaques may enable the early assessment of response to therapy, improve therapy planning, foster the prevention of cardiovascular events and may open the door for the development of patient-specific treatment strategies. (orig.)

  17. Molecular magnetic resonance imaging of atherosclerotic vessel wall disease

    International Nuclear Information System (INIS)

    Molecular imaging aims to improve the identification and characterization of pathological processes in vivo by visualizing the underlying biological mechanisms. Molecular imaging techniques are increasingly used to assess vascular inflammation, remodeling, cell migration, angioneogenesis and apoptosis. In cardiovascular diseases, molecular magnetic resonance imaging (MRI) offers new insights into the in vivo biology of pathological vessel wall processes of the coronary and carotid arteries and the aorta. This includes detection of early vascular changes preceding plaque development, visualization of unstable plaques and assessment of response to therapy. The current review focuses on recent developments in the field of molecular MRI to characterise different stages of atherosclerotic vessel wall disease. A variety of molecular MR-probes have been developed to improve the non-invasive detection and characterization of atherosclerotic plaques. Specifically targeted molecular probes allow for the visualization of key biological steps in the cascade leading to the development of arterial vessel wall lesions. Early detection of processes which lead to the development of atherosclerosis and the identification of vulnerable atherosclerotic plaques may enable the early assessment of response to therapy, improve therapy planning, foster the prevention of cardiovascular events and may open the door for the development of patient-specific treatment strategies. (orig.)

  18. Correlation of common carotid intima media thickness with atherosclerotic cardiovascular events in patients with type 2 diabetes mellitus

    International Nuclear Information System (INIS)

    Vascular complications are a major cause of morbidity and mortality in patients with diabetes mellitus and affect the quality of life. Atherosclerosis, which is the major underlying risk factor, is accelerated in diabetes. To reduce morbidity and mortality, identification of patients with a high risk for development of vascular events is necessary. Apart from other risk prediction models, detection of subclinical atherosclerosis at common carotid site by B-mode ultrasonography which is a noninvasive and reliable method, can add to the benefit and improve risk prediction. Population based studies have revealed that increased Common Carotid Intima Media Thickness (CCIMT) is associated with prevalent coronary artery disease and is a surrogate marker of cardiovascular events. Aim was to evaluate whether increased CCIMT is associated with increased risk of cardiovascular events in patients with type 2 diabetes. A total of 90 patients with type 2 diabetes who were included in the study, were divided in two groups. Group 1: without vascular events and group 2: with vascular events. Apart from patient's demographics, detailed history of events physical examination, through blood analysis for fasting, post postprandial blood sugar, serum cholesterol, TG, renal function test glycosylated Hb, chest x-ray, ECG were recoded. CCIMT was measured by B-mode ultrasonography using high frequency linear transducer, by a specialist radiologist (blind to all clinical and laboratory findings) by standard protocol as described in literature. Mean of the three readings in each side were used for statistical analysis. Our results showed that of the 90 patients studied, 45 diabetes mellitus (DM) patients had atherosclerotic events and significantly higher CCIMT value (mean value of 1.005 +- 0.17 mm) whereas as 45 comparable DM patients without sclerotic events and lower CCIMT values (0.798 +- 0.12 mm) (p0.99 mm) had a statistically significant association with high odds ratios for

  19. Management of post-biopsy renal allograft arteriovenous fistulas with selective arterial embolization: immediate and long-term outcomes

    Energy Technology Data Exchange (ETDEWEB)

    Loffroy, R. [Department of Diagnostic and Interventional Radiology, University of Dijon School of Medicine, Bocage Teaching Hospital, Dijon (France)], E-mail: loffroy.romaric@neuf.fr; Guiu, B.; Lambert, A. [Department of Diagnostic and Interventional Radiology, University of Dijon School of Medicine, Bocage Teaching Hospital, Dijon (France); Mousson, C.; Tanter, Y. [Department of Nephrology and Renal Transplantation (France); Martin, L. [Department of Pathology, University of Dijon School of Medicine, Bocage Teaching Hospital, Dijon (France); Cercueil, J.-P.; Krause, D. [Department of Diagnostic and Interventional Radiology, University of Dijon School of Medicine, Bocage Teaching Hospital, Dijon (France)

    2008-06-15

    Aim: To evaluate the outcomes after transcatheter embolization of percutaneous biopsy-related arteriovenous fistulas in renal allografts. Materials and methods: All post-biopsy renal-transplant vascular injuries referred for embolization between June 1999 and October 2006 were reviewed retrospectively. There were six male and six female patients with a mean age of 49.8 years (range 25-67 years); nine patients were symptomatic, three asymptomatic. Colour Doppler ultrasound (CDUS) and angiography showed one intra-renal arteriovenous fistula in 10 patients and two in two patients, combined with a pseudoaneurysm in six patients. Superselective embolization using a single catheter or coaxial microcatheter was performed with 0.035'' coils or 0.018''microcoils, respectively, in all 12 cases. 24-h creatinine clearance values before (the day of biopsy) and after (7-14 days; 3 months) the procedure were compared using the Wilcoxon signed-rank test. Physical examination and CDUS were performed after 1, 6, and 12 months, and yearly thereafter. Mean follow-up was 33.6 months. Results: Complete definitive occlusion of the fistula was achieved consistently with a single procedure. No procedure-related complications occurred. Renal infarction was minor in all patients (0-10% in nine and 10-20% in three). Symptoms resolved completely. Creatinine clearance values obtained before and after embolization were not statistically different (p = 0.168;.889 respectively). No late recurrences were reported. Conclusion: Transcatheter embolization with coaxial or single-catheter techniques was effective and safe for treating post-biopsy arteriovenous fistulas in renal transplants. The loss of renal parenchyma was minimal and no mid-term deterioration of allograft function was noted. The long-term survival of the renal allograft seemed to be not affected by embolization.

  20. Collagen turnover in arterial disease

    OpenAIRE

    Sluijter, J.P.G.

    2004-01-01

    Increased atherosclerotic plaque formation can lead to lumen reduction and finally to lumen obstruction. Percutaneous transluminal angioplasty (PTA) or balloon angioplasty (dilation) are approaches generally used to treat coronary, but also peripheral atherosclerotic disease. Their goal is to restore the blood supply. The repair process or restructuring of the artery after balloon angioplasty comprises two major features, neointimal formation and geometrical remodeling, and results in a decre...

  1. Leptin and the Regulation of Renal Sodium Handling and Renal Na+-Transporting ATPases: Role in the Pathogenesis of Arterial Hypertension

    OpenAIRE

    Bełtowski, Jerzy

    2010-01-01

    Leptin, an adipose tissue hormone which regulates food intake, is also involved in the pathogenesis of arterial hypertension. Plasma leptin concentration is increased in obese individuals. Chronic leptin administration or transgenic overexpression increases blood pressure in experimental animals, and some studies indicate that plasma leptin is elevated in hypertensive subjects independently of body weight. Leptin has a dose- and time-dependent effect on urinary sodium excretion. High doses of...

  2. Imaging Modalities to Identity Inflammation in an Atherosclerotic Plaque

    International Nuclear Information System (INIS)

    Atherosclerosis is a chronic, progressive, multifocal arterial wall disease caused by local and systemic inflammation responsible for major cardiovascular complications such as myocardial infarction and stroke. With the recent understanding that vulnerable plaque erosion and rupture, with subsequent thrombosis, rather than luminal stenosis, is the underlying cause of acute ischemic events, there has been a shift of focus to understand the mechanisms that make an atherosclerotic plaque unstable or vulnerable to rupture. The presence of inflammation in the atherosclerotic plaque has been considered as one of the initial events which convert a stable plaque into an unstable and vulnerable plaque. This paper systemically reviews the noninvasive and invasive imaging modalities that are currently available to detect this inflammatory process, at least in the intermediate stages, and discusses the ongoing studies that will help us to better understand and identify it at the molecular level

  3. Renal Artery Embolization Combined With Radiofrequency Ablation in a Porcine Kidney Model: Effect of Small and Narrowly Calibrated Microparticles as Embolization Material on Coagulation Diameter, Volume, and Shape

    International Nuclear Information System (INIS)

    The purpose of this study was to evaluate the effect of renal artery embolization with small and narrowly calibrated microparticles on the coagulation diameter, volume, and shape of radiofrequency ablations (RFAs) in porcine kidneys. Forty-eight RFAs were performed in 24 kidneys of 12 pigs. In 6 animals, bilateral renal artery embolization was performed with small and narrowly calibrated microparticles. Upper and lower kidney poles were ablated with identical system parameters. Applying three-dimensional segmentation software, RFAs were segmented on registered 2 mm-thin macroscopic slices. Length, depth, width, volumesegmented, and volumecalculated were determined to describe the size of the RFAs. To evaluate the shape of the RFAs, depth-to-width ratio (perfect symmetry-to-lesion length was indicated by a ratio of 1), sphericity ratio (perfect sphere was indicated by a sphericity ratio of 1), eccentricity (perfect sphere was indicated by an eccentricity of 0), and circularity (perfect circle was indicated by a circularity of 1) were determined. Embolized compared with nonembolized RFAs showed significantly greater depth (23.4 ± 3.6 vs. 17.2 ± 1.8 mm; p segmented (8.6 ± 3.2 vs. 3.0 ± 0.7 ml; p calculated (8.4 ± 3.0 ml vs. 3.3 ± 1.1 ml; p < 0.001); significantly lower depth-to-width (1.17 ± 0.10 vs. 1.48 ± 0.44; p < 0.05), sphericity (1.55 ± 0.44 vs. 1.96 ± 0.43; p < 0.01), and eccentricity (0.84 ± 0.61 vs. 1.73 ± 0.91; p < 0.01) ratios; and significantly greater circularity (0.62 ± 0.14 vs. 0.45 ± 0.16; p < 0.01). Renal artery embolization with small and narrowly calibrated microparticles affected the coagulation diameter, volume, and shape of RFAs in porcine kidneys. Embolized RFAs were significantly larger and more spherical compared with nonembolized RFAs.

  4. Experimental Embolization of Rabbit Renal Arteries to Compare the Effects of Poly L-Lactic Acid Microspheres With and Without Epirubicin Release Against Intraarterial Injection of Epirubicin

    International Nuclear Information System (INIS)

    Purpose: We performed a basic investigation using white rabbits of the sustained release and embolizing effects of poly L-lactic acid microspheres (PLA) to determine their usefulness for chemoembolization.Methods: Fifteen male Japanese white rabbits were used. Sustained release of an embolizing material, EPI-PLA was accomplished with 1 mg of PLA containing 0.03 mg of epirubicin hydrochloride (EPI). Embolization with 50 mg of PLA (total dose of EPI 1.5 mg) was performed after the renal artery of the rabbits was selected (Chemo-TAE group). A group in which a bolus of 1.5 mg EPI alone was injected through the renal artery (TAI group) was established as a control group. Furthermore, a group in which embolization was performed with 50 mg of PLA alone (TAE group) was also established. These three groups, each consisting of five rabbits, were compared.Results: Blood EPI levels were serially measured. The blood EPI level in the TAI group rapidly reached a peak more than 30 min after injection, then decreased to almost zero 24 hr after injection. In the Chemo-TAE group, the blood EPI level was transiently increased 30 min after embolization, but remained low thereafter until 24 hr after embolization. EPI levels in kidney tissue isolated 24 hr after embolization were measured. In the Chemo-TAE group, the tissue EPI level was significantly higher than that in the TAI group. When isolated kidneys were macroscopically and histologically examined, atrophy of the entire embolized kidney, as well as infarction and necrosis in the renal cortex, were observed in both the TAE group and the Chemo-TAE group. However, there were no such findings in the TAI group. The area of the infarction in the renal cortex did not significantly differ between the Chemo-TAE group and the TAE group; however, there was vascular injury in the Chemo-TAE group and none in the TAE group.Conclusion: It was demonstrated that EPI-PLA, a chemoembolizing material, maintained high local concentrations of the

  5. Experimental embolization of rabbit renal arteries to compare the effects of poly L-lactic acid microspheres with and without epirubicin release against ntraarterial injection of epirubicin

    International Nuclear Information System (INIS)

    Purpose: We performed a basic investigation using white rabbits of the sustained release and embolizing effects of poly L-lactic acid microspheres (PLA) to determine their usefulness for chemoembolization.Methods: Fifteen male Japanese white rabbits were used. Sustained release of an embolizing material, EPI-PLA was accomplished with l m g of PLA containing 0.03 mg of epirubicin hydrochloride (EPI). Embolization with 50 mg of PLA (total dose of EPI l.5 mg) was performed after the renal artery of the rabbits was selected (Chemo-TAE group). A group in which a bolus of 1.5 mg EPI alone was injected through the renal artery (TAI group) was established as a control group. Furthermore, a group in which embolization was performed with 50 mg of PLA alone (TAE group) was also established. These three groups, each consisting of five rabbits, were compared.Results: Blood EPI levels were serially measured. The blood EPI level in the TAI group rapidly reached a peak more than 30 min after injection, then decreased to almost zero 24 hr after injection. In the Chemo-TAE group, the blood EPI level was transiently increased 30 min after embolization, but remained low thereafter until 24 hr after embolization. EPI levels in kidney tissue isolated 24 hr after embolization were measured. In the Chemo-TAE group, the tissue EPI level was significantly higher than that in the TAI group. When isolated kidneys were macroscopically and histologically examined, atrophy of the entire embolized kidney, as well as infarction and necrosis in the renal cortex, were observed in both the TAE group and the Chemo-TAE group. However, there were no such findings in the TAI group. The area of the infarction in the renal cortex did not significantly differ between the Chemo-TAE group and the TAE group; however, there was vascular injury in the Chemo-TAE group and none in the TAE group.Conclusion: It was demonstrated that EPI-PLA, a chemo-embolizing material, maintained high local concentrations of the

  6. Human urotensin II promotes hypertension and atherosclerotic cardiovascular diseases.

    Science.gov (United States)

    Watanabe, Takuya; Arita, Shigeko; Shiraishi, Yuji; Suguro, Toshiaki; Sakai, Tetsuo; Hongo, Shigeki; Miyazaki, Akira

    2009-01-01

    Human urotensin II (U-II), the most potent vasoconstrictor undecapeptide identified to date, and its receptor (UT) are involved in the pathogenesis of systemic and pulmonary hypertension. Here, we review recent advances in our understanding of the pathophysiology of U-II with particular reference to its role in atherosclerotic cardiovascular diseases. Single-nucleotide polymorphisms of U-II gene (S89N) are associated with onset of essential hypertension, type II diabetes mellitus, and insulin resistance in the Asian population. Plasma U-II levels are elevated in patients with vascular endothelial dysfunction-related diseases such as essential hypertension, diabetes mellitus, atherosclerosis, ischemic heart disease, and heart failure. Chronic infusion of U-II enhances atherosclerotic lesions in the aorta in apolipoprotein E-knockout mice. In human atherosclerotic plaques from the aorta and coronary and carotid arteries, U-II is expressed at high levels in endothelial cells (ECs) and lymphocytes, whereas UT is expressed at high levels in vascular smooth muscle cells (VSMCs), ECs, monocytes, and macrophages. U-II stimulates vascular cell adhesion molecule-1 and intercellular adhesion molecule-1 expression in human ECs as chemoattractant for monocytes, and accelerates foam cell formation by up-regulation of acyl-coenzyme A:cholesterol acyltransferase-1 in human monocyte-derived macrophages. U-II produces reactive oxygen species (ROS) via nicotinamide adenine dinucleotide phosphate oxidase activation in human VSMCs, and stimulates VSMC proliferation with synergistic effects when combined with ROS, oxidized LDL, and serotonin. Clinical studies demonstrated increased plasma U-II levels in accordance with the severity of carotid atherosclerosis in patients with essential hypertension and that of coronary artery lesions in patients with ischemic heart disease. Here, we summarize the key roles of U-II in progression of hypertension and atherosclerotic cardiovascular diseases

  7. Acute renal failure and arterial hypertension due to sub capsular hematoma: is percutaneous drainage a feasible treatment?

    DEFF Research Database (Denmark)

    Kobel, Marie Cæcilie; Nielsen, Tommy Kjærgaard; Graumann, Ole

    Percutaneous drainage proved to be successful in managing a renal subcapsular haematoma that was causing acute renal failure and hypertension in a 74-year-old woman. The patient presented with oliguria, nausea and malaise 2 days after a ureteronephroscopic procedure with biopsies of a suspected...... did not respond to antihypertensive treatment, Page kidney was suspected. A pigtail catheter was placed in the haematoma and, shortly after drainage, the diuresis resumed and plasma creatinine together with blood pressure decreased. This condition had previously been managed by open surgery, but...... recent case reports have described successful management by laparoscopy-assisted and radiology-assisted drainage, as described in this case report....

  8. Superficial temporal artery calcification in patients with end-stage renal disease: Association with vascular risk factors and ischemic cerebrovascular disease

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    Zeeshan Anwar

    2011-01-01

    Full Text Available Background and Purpose: Extracranial superficial temporal artery (STA calcification is an unusual finding seen in patients with chronic kidney disease and has unknown ramifications with respect to intracranial ischemic disease. We sought to determine the association between the risk factors for vascular calcification and this rare phenomenon, in patients with chronic renal failure, and to assess the coexistence of cerebral ischemia. Materials and Methods: Medical records and laboratory data on risk factors for vascular calcification were retrospectively retrieved for 453 patients with a discharge diagnosis of end-stage renal disease (ESRD. CT head examinations were reviewed to identify and associate STA calcification with 1 risk factors for the vascular calcification, 2 intracranial artery calcification, and 3 cerebral ischemia (white matter and/or cortical ischemic changes. Results: STA calcification was present in 9.9% (45/453 of the studied cohort. The prevalence of cerebral ischemia was 24.4% (11/45 in patients with STA calcification and 9.3% (38/408 in patients without it. Diabetes mellitus (OR: 2.56, 95% CI: 1.059-6.208; P=0.037 was independently associated with the risk of STA calcification. The risk of cerebral ischemia, however, was not related to STA calcification (P=0.221. Conclusion: The presence of diabetes mellitus is important in describing the risk of STA calcification in patients with ESRD, whereas age, gender, hypertension, serum calcium, serum phosphate, or serum hemoglobin levels are not. The risk of cerebral ischemia is not related to STA calcification but has the strongest association with diabetes mellitus.

  9. Significance of MR angiography in the diagnosis of aberrant renal arteries as the cause of ureteropelvic junction obstruction in children; Stellenwert der MR-Angiografie in der Diagnostik aberrierender Nierenarterien als Ursache einer Ureterabgangsstenose bei Kindern

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    Ritter, L.; Sorge, I.; Hirsch, F.W.; Vieweger, A. [Leipzig Univ. (Germany). Dept. of Pediatric Radiology; Goetz, G.; Lehnert, T.; Buehligen, U.; Geyer, C. [Leipzig Univ. (Germany). Dept. of Pediatric Surgery

    2015-01-15

    To determine the importance of MRI with contrast-enhanced MRA for the detection or exclusion of aberrant or obstructing renal arteries in ureteropelvic junction obstruction in children. Key word-based search in RIS database (ureteropelvic junction obstruction/MRI) and retrospective comparison of arterial findings from preoperative contrast-enhanced MRA and intra-operative inspection. From 2007 to 2013, 19 children with ureteropelvic junction obstruction underwent contrast-enhanced MRA. Based on the results of the MRI scan and MAG3 scintigraphy, the children were referred to surgery (Anderson-Hynes-pyeloplasty). An aberrant renal artery was diagnosed with MRI in 14 of 19 children, and intra-operative inspection confirmed 13 of those 14. In the remaining 5 children, no aberrant vessel could be observed in MRI and this was confirmed intra-operatively in 3 of the 5 cases, while in the remaining 2, an aberrant vessel was found. Of the 14 children with aberrant vessels, 12 underwent surgery due to assumed ureteral obstruction, which was confirmed by surgery in 11 cases. In one case, an aberrant artery was found intra-operatively, but obstruction could not be confirmed. In one of the 14 children, the vessel was found in MRI, but its obstructing character was negated via MRA, which was confirmed intra-operatively. In the diagnosis of aberrant and obstructing renal arteries, contrast-enhanced MRA presents 85 % sensitivity and 80 % specificity, with a positive predictive value of 0.8. MRI with contrast-enhanced MRA is suitable to detect aberrant and obstructing renal arteries. An obstructive effect of the aberrant vessel is to be assumed if the vessel has a close relationship to the ureteropelvic junction and if it is linearly stretched.

  10. The Use of Carotid Artery Ultrasonography in Different Clinical Conditions

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    Gasparyan, Armen Yuri

    2009-01-01

    B-mode ultrasonography of the carotid artery is a non-invasive, informative and reproducible technique used for the assessment of prevalence and course of atherosclerosis in a variety of clinical conditions. Visualization of intima-media complex, atherosclerotic plaques, rough arterial wall and calcifications of the carotid artery may be useful for the assessment of atherosclerotic burden. The latter was confirmed in a recent consensus statement of the American Society of Echocardiography. De...

  11. Multidetector computed tomography of the coronary arteries - pictorial essay

    International Nuclear Information System (INIS)

    Multidetector computed tomography (MDCT) is being used more frequently for the detection of atherosclerotic coronary artery disease (CAD). MDCT allows for very rapid image acquisition with little motion artifact, resulting in the ability to quantitate calcified atherosclerotic plaque. Congenital coronary artery anomalies are readily identified using this technique. A key advantage is the noninvasiveness of the study, with no intravascular contrast media needed. Knowledge of coronary artery anatomy as well as of the potential pitfalls is required. (author)

  12. The content of copper and zinc in human ulcered atherosclerotic plaque

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    Radak Đorđe

    2004-01-01

    Full Text Available INTRODUCTION Copper and zinc have significant antiatherogenic effect influencing activity of antioxidant enzyms (giutathion-peroxidase i superoxid-dismutase, mechanism of apoptosis and other mechanisms. Few studies showed increased copper and zinc concentration in atherosclerotic plaque in comparison to normal vascular tissue. AIM The aim of the study was to compare copper and zinc concentrations in carotid artery tissue without significant atherosclerotic changes and human ulcered atherosclerotic plaque. MATERIAL AND METHODS Study was conducted on 66 patients. Carotid endarterectomy due to the significant carotid atherosclerotic changes with cerebrovascular disorders was performed in 54 patients (81.8%. Control group consisted of 12 patients (18.2% without carotid atherosclerotic changes operated due to the symptomatic kinking and coiling of carotid artery. Operated group consisted of 38 man (62.96% and 16 woman (37.04%. Control group had the same number of patients: six men (50% and six women (50%. Preoperatively, all patients were examined by vascular surgeon, neurologist and cardiologist. Duplex sonografy of carotid and vertebral arteries was performed by Aloca DSD 630 ultrasound with mechanical and linear transducer 7.7 MHz. Indication for surgical treatment was obtained according to non-invasive diagnostic protocol and neurological symptoms. Copper and zinc concentration in human ulcered atherosclerotic plaque and carotid artery segment were estimated by spectophotometry (Varian AA-5. RESULTS Average age of our patients was 59.8±8.1 years. For males average age was 76.1 ±9.8 years. And for females 42.4±5.8 years. In group with carotid endarterectomy female patients were significantly younger than male patients (p<0.01. In group with carotid endarterectomy clinically determined neurological disorders were found in 47 patients (87.03%-35 male (74.47% and 12 female patients (25.53%. Regarding risk factors for cardiovascular diseases, no

  13. Arterially transplanted mesenchymal stem cells in a mouse reversible unilateral ureteral obstruction model: in vivo bioluminescence imaging and effects on renal fibrosis

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    BAI Zhi-ming; DENG Xiang-dong; LI Jin-dong; LI Dong-hui; CAO Hui; LIU Zhen-xiang; ZHANG Jie

    2013-01-01

    Background Chronic kidney disease (CDK) is a worldwide health problem,but there is currently no effective treatment that can completely cure this disease.Recently,studies with mesenchymal stem cells (MSCs) on treating various renal diseases have shown breakthroughs.This study is to observe the homing features of MSCs transplanted via kidney artery and effects on renal fibrosis in a reversible unilateral ureteral obstruction (R-UUO) model.Methods Thirty-six Balb/c mice were divided into UUO group,UUO-MSC group,and sham group randomly,with 12 mice in each group.The MSCs had been infected by a lentiviral vector to express stably the luciferase reporter gene and green fluorescence protein genes (Luc-GFP-MSC).Homing of MSCs was tracked using in vivo imaging system (IVIS) 1,3,14,and 28 days after transplantation.Imaging results were verified by detecting GFP expression in frozen section under a fluorescence microscope.E-cadherin,α-SMA,TGF-β1,and TNF-α mRNA expression in all groups at 1 and 4 weeks after transplantation were analyzed by quantitative PCR.Results Transplanted Luc-GFP-MSCs showed increased Luciferase expression 3 days after transplantation.The expression decreased from 7 days,weakened thereafter and could not be detected 14 days after transplantation.Quantitative PCR results showed that all gene expressions in UUO group and UUO-MSC group at 1 week had no statistical difference,while at 4 weeks,except TGF-β expression (P>0.05),the expression of E-cadherin,α-SMA,and TNF-α in the above two groups have statistical difference (P<0.01).Conclusion IVIS enables fast,noninvasive,and intuitive tracking of MSC homing in vivo.MSCs can be taken home to kidney tissues of the diseased side in R-UUO model,and renal interstitial fibrosis can be improved as well.

  14. Peripheral Arterial Disease. Contrast-Enhanced 3D MR Angiography of the Lower Leg and Foot Compared with Conventional Angiography

    International Nuclear Information System (INIS)

    Purpose: To determine whether contrast-enhanced 3D MR angiography (CE MRA) could replace digital subtraction angiography (DSA) for the evaluation of atherosclerotic peripheral vascular disease of the lower leg and foot. Material and Methods: Thirty-five patients with symptoms of atherosclerotic disease of the leg were examined prospectively with CE MRA of the foot and the lower legs as well as with DSA from the aorta to the pedal arches. The MRA technique was focused on optimal imaging of the arteries of the foot. Results: The agreement between CE MRA and DSA for grading of stenosis was moderate to good (weighted -values 0.48-0.80). The sensitivity of CE MRA for detection of significant stenosis (50%) was 92% and the specificity was 64% with DSA as gold standard. Conclusion: CE MRA is a fairly accurate method for the demonstration of atherosclerotic disease below the knee including the pedal arches. It can replace DSA for the assessment of distal arteries in patients with impaired renal function. However, image quality and resolution still needs to be improved before CE MRA can become the method of choice in all patients

  15. Peripheral Arterial Disease. Contrast-Enhanced 3D MR Angiography of the Lower Leg and Foot Compared with Conventional Angiography

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    Cronberg, C.N.; Albrechtsson, U.; Larsson, E.M. [Univ. Hospital, Lund (Sweden). Center for Medical Imaging and Physiology; Sjoeberg, S.; Leander, P.; Lindh, M. [Univ. Hospital, Malmoe (Sweden). Dept. of Diagnostic Radiology; Norgren, L.; Danielsson, P.; Sonesson, B. [Univ. Hospital, Malmoe (Sweden). Dept. of Vascular Surgery

    2003-03-01

    Purpose: To determine whether contrast-enhanced 3D MR angiography (CE MRA) could replace digital subtraction angiography (DSA) for the evaluation of atherosclerotic peripheral vascular disease of the lower leg and foot. Material and Methods: Thirty-five patients with symptoms of atherosclerotic disease of the leg were examined prospectively with CE MRA of the foot and the lower legs as well as with DSA from the aorta to the pedal arches. The MRA technique was focused on optimal imaging of the arteries of the foot. Results: The agreement between CE MRA and DSA for grading of stenosis was moderate to good (weighted -values 0.48-0.80). The sensitivity of CE MRA for detection of significant stenosis (50%) was 92% and the specificity was 64% with DSA as gold standard. Conclusion: CE MRA is a fairly accurate method for the demonstration of atherosclerotic disease below the knee including the pedal arches. It can replace DSA for the assessment of distal arteries in patients with impaired renal function. However, image quality and resolution still needs to be improved before CE MRA can become the method of choice in all patients.

  16. Atherosclerotic Calcification Detection: A Comparative Study of Carotid Ultrasound and Cone Beam CT

    OpenAIRE

    Fisnik Jashari; Pranvera Ibrahimi; Elias Johansson; Jan Ahlqvist; Conny Arnerlöv; Maria Garoff; Eva Levring Jäghagen; Per Wester; Michael Y. Henein

    2015-01-01

    BACKGROUND AND AIM: Arterial calcification is often detected on ultrasound examination but its diagnostic accuracy is not well validated. The aim of this study was to determine the accuracy of carotid ultrasound B mode findings in detecting atherosclerotic calcification quantified by cone beam computed tomography (CBCT). METHODS: We analyzed 94 carotid arteries, from 88 patients (mean age 70 ± 7 years, 33% females), who underwent pre-endarterectomy ultrasound examination. Plaques with high ec...

  17. Neoatherosclerosis: Coronary stents seal atherosclerotic lesions but result in making a new problem of atherosclerosis

    OpenAIRE

    Komiyama, Hidenori; Takano, Masamichi; Hata, Noritake; Seino, Yoshihiko; Shimizu, Wataru; Mizuno, Kyoichi

    2015-01-01

    Chronic inflammation of the native vessel wall with infiltration of lipid-laden foamy macrophages through impaired endothelium results in atherosclerosis. Percutaneous coronary intervention, including metallic stent implantation, is now widely utilized for the treatment of atherosclerotic lesions of the coronary artery. Bare-metal stents and the subsequently developed drug-eluting stents seal the atherosclerosis and resolve lumen stenosis or obstruction of the epicardial coronary artery and m...

  18. Evaluation of curative effect of interventional therapy for chronic simple atherosclerotic occlusive disease of lower extremity

    International Nuclear Information System (INIS)

    Objective: To explore the efficacy and influencing factors of interventional therapy for chronic atherosclerotic occlusive disease of the lower extremity. Methods: 56 cases of simple atherosclerotic occlusive disease of lower extremity were divided into 3 types according to the location of occlusion, including 17 cases of abdominal aorta-iliac artery, 18 cases of iliac-femoral artery, and 21 cases of femoropopliteal inferior genicular artery. Catheter and guide were combined with blunt dissection and subtle banding were used to dredge the occluded vessels, and the stents were implanted when interlayer appeared. Results: After the treatment, 46 cases of occlusion were dredged (82.1%), 6 cases remained occluded with the same symptoms (10.7%), and 4 cases had severer symptoms (7.1%). Among the 46 successful cases, there were 16 cases of abdominal aorta-iliac artery (94.1%), 16 cases of iliac-femoral artery (88.9%) and 14 cases of femoropopliteal inferior genicular artery (66.6%). There was no statistical difference between the abdominal aorta-iliac artery cases and iliac-femoral artery cases (P>0.05), but the rate of abdominal aorta-iliac artery was higher than that of femoropopliteal inferior aorta-iliac artery (P0.05), but there were significant differences between the first two types and the third type (P<0.05). Compared with the 14 dredged cases (71.4%), 7 cases (33.3%) of undredged femoropopliteal inferior genicular artery cases had richer compensatory circulation(P<0.05). Conclusion: It is safe and effective to treat simple atherosclerotic occlusive disease of the lower extremity with interventional therapy. The location and length of occlusion and the abundance of compensatory circulation have effects on the therapy. (authors)

  19. Case report: Varicosity of the communicating vein between the left renal vein and the left ascending lumbar vein mimicking a renal artery aneurysm: Report of an unusual site of varicose veins and a novel hypothesis to explain its association with abdominal pain

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    Sandeep G Jakhere

    2011-01-01

    Full Text Available A communicating vein between the left renal vein and the left ascending lumbar vein has only rarely been reported in the imaging literature. There are very few reports of varicosity of this communicating vein. Nonetheless, awareness about this communicating vein is of utmost importance for surgeons performing aortoiliac surgeries and nephrectomies as it may pose technical difficulties during surgery or cause life-threatening retroperitoneal hemorrhage. Varicosity of this venous channel may be mistaken for paraaortic lymphadenopathy, adrenal pseudo-mass, or renal artery aneurysm. We report a case of a patient with varicosity of this communicating vein, which mimicked a left renal artery aneurysm. A novel hypothesis is also proposed to explain the relationship with abdominal pain.

  20. A rare variant route of the ulnar artery does not contraindicate the creation of a fistula in the wrist of a diabetic patient with end-stage renal disease

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    Mirosław Banasik

    2011-10-01

    Full Text Available A superficial variant route of the ulnar artery is a rare variation of the arterial system of the wrist. The route of the arteries in that region is extremely important for patients with end-stage renal disease due to the necessity to create an arteriovenous fistula for hemodialysis. It is thought that the vascular access is too often achieved by catheters or vascular prostheses because of that each possibility to create a fistula in the wrist region should be utilized. In our patient a rare variant route of the ulnar artery was observed in the wrist region. Instead of a deep route between the muscles the artery did not only run superficially, but, also untypically, first laterally and then medially. A variation of the ulnar artery’s route may evoke a fear of hand ischemia after creation arteriovenous fistula for hemodialysis. The fear may be connected with blood supply throw the palmar arch which is created by radial and ulnar artery. This fear of the doctor may result in avoiding the attempt to create an arteriovenous fistula on the wrist. The authors demonstrate that the variant route of the ulnar artery is not a contraindication to the creation of a fistula on the wrist using the radial artery because of a fear of hand ischemia.

  1. Amputation of extremity in patients with atherosclerotic gangrene

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    Tsareva Yu.O.

    2011-12-01

    Full Text Available Aim of investigation — to analyze the results of treatment of patients with atherosclerotic gangrene of a limb, to identify the causes of adverse outcomes amputation. Materials and methods: We analyzed the results of examination and treatment of 218 patients with atherosclerotic gangrene of the limb. Good outcome of amputation was considered the primary surgical wound healing of the stump. Suppuration, secondary healing, re-amputation and death we attributed to the adverse results of amputation. Results: The adverse outcomes of amputation due to technical errors in surgery, properly chosen level, inadequate drainage of the wound stump, an unsuccessful operation on the arteries of a limb, inadequate empirical antibiotic therapy, patient's age, functional capabilities of myocardium, the duration of critical ischemia, as well as the lack of psychological adaptation of patients before amputation. Conclusion: To decide the need for amputation in patients with atherosclerotic gangrene follows the assessment of possible vascular reconstructive surgery. In determining the level of amputation is necessary to objectively assess the degree of disruption of regional blood flow using multilevel manometry and laser Dopplerflowmetry. In preparation for amputation should be paid special attention to the correction of rheological and coagulation properties of blood, normalization of the functional state of the myocardium, as well as specialized psychotherapeutic training for timely and adequate psychological adaptation of the patient

  2. Influência do bloqueador de receptor de angiotensina (Losartana potássica na função renal e pressão arterial em cães GRMD Influence of angiotensin receptor blocker of renal function and arterial pression in GRMD dogs

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    Marina Brito Silva

    2009-04-01

    Full Text Available A distrofia muscular de Duchenne (DMD é uma alteração neuromuscular caracterizada por contínua necrose muscular e degeneração, com eventual fibrose e infiltração por tecido adiposo. O aumento progressivo da fibrose intersticial no músculo impede a migração das células miogênicas, necessárias para a formação muscular. O modelo canino constitui-se nas melhores fenocópias da doença em humanos, quando comparados com outros modelos animais com distrofia. O tratamento antifibrose de pacientes DMD, tendo como alvo os mediadores da citocina, TGF-beta, e o tratamento com antiinflamatórios, podem limitar a degeneração muscular e contribuir para a melhora do curso da doença. O presente estudo teve como objetivo observar os possíveis efeitos adversos na fisiologia renal, por meio de avaliação bioquímica sanguínea e da pressão arterial, verificando a viabilidade do uso do Losartan (um inibidor de TGF-beta nos cães afetados pela distrofia muscular. Foram utilizados quatro cães adultos, sendo dois machos e duas fêmeas. Utilizou-se a dose de 50mg de Losartan, administrada via oral, uma vez ao dia. Os exames clínicos, bem como alterações na função renal, o nível do potássio sérico e a pressão arterial não evidenciaram reação adversa durante todo o período do experimento. O uso de Losartan, por um período de 9 semanas, mostrou-se como uma terapia segura para o tratamento antifibrótico em cães adultos, não afetando a função renal ou pressão arterial dos animais.Duchenne muscular dystrophy (DMD is a neuromuscular disorder characterized by a continuous muscle necrosis and degeneration with eventual fibrosis and fatty