Superselective transcatheter renal artery embolization for the treatment of hemorrhage from non-iatrogenic blunt renal trauma: report of 16 clinical cases Dapang Rao,1 Haifeng Yu,2 Haibo Zhu,2 Kaiyuan Yu,2 Xiao Hu,3 Liping Xie11Department of Urology, First Affiliated Hospital, Medical College, Zhejiang University, Hangzhou, People's Republic of China; 2Department of Urology, Second Affiliated Hospital of Wenzhou Medical College, Wenzhou, People’s Republic of China; 3Zhejiang University Medical College, Hangzhou, People’s Republic of ChinaObjective: To explore the therapeutic efficacy and outcome of superselective transcatheter renal artery embolization for the treatment of hemorrhage from non-iatrogenic blunt renal trauma (BRT).Methods: Sixteen patients who received superselective transcatheter renal artery embolization for non-iatrogenic BRT hemorrhage between January 2003 and December 2012 were reviewed retrospectively. Spring steel coils with gelatin sponge particles were used to
... imaging evaluates blood flow velocities and patterns in the aorta and renal arteries. According to the American College of Radiology, "Ultrasound using grayscale imaging, Doppler spectral analysis, and color Doppler imaging is a proven and useful procedure for evaluating the renovascular system.". Many patients with hypertension are referred for a renal artery duplex because of their increased risk of renal artery stenosis. Some cases of renovascular hypertension actually develop as a result of an obstruction in the renal arteries. These cases of hypertension can usually be effectively treated by treating the obstruction.. Flow patterns within the kidneys can provide information about damage to the kidneys and extent of renal artery disease from chronic poor blood flow. Color Doppler can show renal artery perfusion and venous return. It may also be used to determine renal transplant rejection.. Indications:. ...
Our study confirms that high-frequency electric stimulation of nerves in renal arteries (RNS), both main and accessory, elicits a substantial BP increase. The amplitude of BP increase after RNS in accessory arteries was similar to that observed in main renal artery trunks, suggesting that sympathetic fibers innervating accessory arteries may play an important role in patients with resistant hypertension. In agreement with our previous work,15 successful RDN of main renal arteries led to a substantial blunting of RNS-related BP increase after electric stimulation of denervated arteries. However, RNS of (nondenervated) accessory arteries was associated with an unchanged BP increase. This residual source of sympathetic activity may explain the lesser benefits of incomplete RDN limited to the main renal artery trunks in patients with accessory arteries.11,12. Our findings may prove to be of major practical relevance. Indeed, the prevalence of renal accessory and multiple arteries varies between 15% ...
Recent studies have indicated that renal arteries can produce 20-hydroxyeicosatetraenoic acid (20-HETE) and suggest the potential involvement of a P450 metabolite of arachidonic acid in the myogenic activation of canine renal arteries. In the present study, the effects of 20-HETE on isolated canine renal arcuate arteries were studied. Administration of 20-HETE to the bath or the lumen at concentrations of 0.01-1 microM produced a graded reduction in the diameter of these vessels. In contrast, 19(R)-HETE was a vasodilator, whereas 19(S)-HETE was relatively inactive. The vasoconstrictor response to 20-HETE was not altered by the cyclooxygenase inhibitor indomethacin, endoperoxide/thromboxane receptor antagonist SQ29548, or combined blockade of the cyclooxygenase, lipoxygenase, and P450 pathways using indomethacin, baicalein, and 7-ethoxyresorufin. The response to 20-HETE was associated with depolarization and a sustained increase in the intracellular calcium concentration in renal vascular smooth ...
We performed EVAR using Gore Excluder. At first, mainbody was implanted under the left renal artery. Next, on the proximal site, wedelivered aortic extender and Zilver stent in advance. After aortic extenderwas implanted just under the right renal artery, we implanted the Zilver stentfor left renal artery. And, final KBT (Kissing balloon technique) was done. Anyendoleak was not detected by final angiography and both side of renal arteryflow was enough. One day after procedure, serum creatinine level increased onblood test. Because we did not detect reduction of renal flow by duplexultra-sonography, we observed as contrast nephropathy. But, serum creatininelevel did not improve. Accordingly, we checked the CT imaging. We weresuspicious of right renal artery occlusion due to stent graft. And, we decided to perform re-intervention for right renalartery occlusion. We inserted 5 Frguiding sheath from right brachial artery. Initial angiogram revealed rightrenal occlusion. After wire crossing with ...
Knowledge of anatomical features of the renal artery is important in prediction, management and control of atherosclerotic renal artery stenosis. These features show population variations but data from black African populations are scarce. The aim of this study was therefore to describe the anatomical features of the renal artery in a black Kenyan population. Six hundred and ten (610) single renal arteries from 305 adult black Kenyans [206 males, 99 females; age range 22 - 79 years] were studied by dissection at Department of Human Anatomy, University of Nairobi, Kenya. Specimens with macroscopic features of stenosis and dilatation were excluded. The implantation angle, length and branching pattern were studied. These features were correlated with intima-media thickness and luminal diameter. The latter were determined by micrometry on Eosin/hematoxylin stained 5 micron sections obtained from the proximal segment of the renal artery. Data was analysed by SPSS version 16.0. Students t-test, was ...
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...
Another name for Renal Artery Thrombosis is Renal Artery Occlusion. Renal artery occlusion may occur suddenly or gradually. A sudden renal artery occlusion ...
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One-kidney, one clip (1K1C) and two-kidney, one clip (2K1C) Goldblatt hypertension was produced in rats by placing 0.30, 0.25, or 0.20 mm silver clips on the left renal artery. Mean arterial pressure (MAP) and plasma renin activity (PRA) were measured in conscious rats 24 to 28 days after clipping. The MAP in control rats (n = 38) was 116 +/- 1 mm Hg (mean +/- SEM). The 0.30, 0.25, and 0.20 mm clips produced MAPs of 133 +/- 2, 161 +/- 5, and 189 +/- 5 mm Hg, respectively, in 1K1C rats, and 123 +/- 2, 129 +/- 3, and 172 +/- 5 mm Hg in 2K1C rats (n = 17-20). When 1K1C and 2K1C groups were compared, MAP was significantly greater in 1K1C rats at all clip sizes. No treatment groups PRA was different than control (4.8 +/- 0.4 ng AI/ml/hr), except for the 0.20 mm 2K1C rats (16.2 +/- 3.1 ng AI/ml/hr). Renal artery pressure (RAP) was measured in another series of experiments and was not different from control in all but the 0.20 mm 1K1C rats. With identical clip sizes, 2K1C rats showed smaller pressure ...
Accessory renal arteries are a common variant and are present in ~25% (range 20-30%) and are bilateral in ~10% of the population 7. Their proper identification is of utmost importance for surgical planning prior to live donor transplantation 2,3 ...
We have investigated the effects of recombinant human erythropoietin (EPO) on the responses of rat renal arcuate arteries to dopamine, noradrenaline and acetylcholine and on the release of NO from human umbilical vein endothelial cells (HUVEC) in culture. Noradrenaline induced a concentration-dependent constriction and acetylcholine a concentration-dependent relaxation of the vessels. The effects of dopamine were concentration-dependent, leading to relaxation of the vessels at low concentrations and contraction of the vessels at high concentrations. NG-Nitro-L-arginine methyl ester (L-NAME; 0.1 mM) did not change the vasoconstrictor responses to noradrenaline and dopamine, but inhibited the acetylcholine- and dopamine-induced vasorelaxation. Neither 0.1 nor 20 units·ml-1 EPO affected noradrenaline-induced constriction, or dopamine- or acetylcholine-induced relaxation, of the vessels. EPO at 20 units·ml-1 attenuated dopamine-induced constriction of the vessels. This effect was blunted by ...
The kidney receive 20-25 percent of the total cardiac output. In normal healthy individuals, about 1200ml of blood flows through the kidneys each minute. The blood supply to each kidney is usually a single renal artery originates along the lateral surface of the adominal aorta near the level of the superior mesenteric artery. However, there may sometimes be additional small vessels from superior mesenteric, adrenal, spermatic or ovarian arteries.. Almost all of the blood which enters the kidneys at renal hilus, via the renal artery. The renal artery branches to form several interlobar arteries which radiate outward through the renal column between the renal pyramids. The interlobar arteries subdivide themselves to arcuate arteries, which pass along the boundary between cortex and medulla. Each arcuate artery branches and travel out at a right angle, through the cortex towards the capsule and gives rise to a number of interlobular arteries, which supply the cortical portions of the adjacent renal ...
My peak systolic velocity of right renal artery is 95 cm/sec whereas left renal artery is 215cm/sec. (Normal being around 100cm/sec) with turbulence in the mid arterial segment. My renal artery to aortic ratio is within normal limits at 1.24. There may be a stenosis and it may not be hemodynamically significant ...
Renal artery disease is a form of peripheral artery disease that reduces blood flow through the renal arteries, which supply blood to the kidneys
Renal artery disease is a form of peripheral artery disease that reduces blood flow through the renal arteries, which supply blood to the kidneys
Looking for intrarenal arteries? Find out information about intrarenal arteries. blood vessel that conveys blood away from the heart heart, muscular organ that pumps blood to all parts of the body. The rhythmic beating of the heart is a... Explanation of intrarenal arteries
The importance of beta and gamma epithelial Na(+) channel (ENaC) proteins in vascular smooth muscle cell (VSMC)-mediated pressure-induced constriction in renal interlobar arteries has been demonstrated recently. In renal epithelial tissue, ENaC expre
Archives of cardiovascular diseases - Vol. 104 - N° 5 - p. 363-364 - Iconography : Coexisting renal artery aneurysm and adrenal adenoma in resistant hypertension - EM|consulte
Often clinically silent and discovered incidentally, FMD accounts for less than 10% of cases of renal artery stenosis (RAS), and although it can affect the intima, in the majority of cases it involves the media, resulting in the typical "string of beads" appearance (Figure 32-1).1 The cause remains largely unknown; however it may have a genetic component and it is more frequent in hypertensive patients and smokers.2 FMD usually affects women between 15 and 50 years of age, but it can be also observed in males and older patients as well.1 It occurs most frequently in the renal artery, but can also involve the carotid and vertebral arteries, sometimes in association with intracranial aneurysms, as well as other visceral vessels.1,3,4 ...
The aim of this trial is a prospective, randomized comparison of three different techniques for catheter based renal sympathetic denervation. Patients with larger (,5.5 mm) renal arteries are randomized to a treatment with a radiofrequency based catheter of the main renal artery, the main renal artery, its side-branches and accessories or an ultrasound-based denervation of the main renal artery only. The primary endpoint is the change in daytime blood pressure acquired in ambulatory blood pressure measurement at 3 months ...
Another name for Renal Artery Occlusion is Renal Artery Occlusion. The following are some important questions to ask before and after the treatment of ...
A new study published in Journal of endovascular therapy (2014;21:181-190) has evaluated the efficacy of renal denervation therapy for hypertension refractory to renal artery stenting.. The study included ten patients (6 women; mean age 70.0±5.1 years) with an office systolic blood pressure ,160 mmHg despite taking ≥3 antihypertensive drugs and uni- or bilateral renal artery stenting. These patients were treated with RDN. Radiofrequency (RF) energy was delivered to the native segment of the artery keeping a 5-mm safe distance from the stented segments. Standardized office and ambulatory blood pressure measurements, medication, and renal assessment, including renal duplex ultrasound and renal function, were determined at baseline and on follow-up to 12 months.. ...
There have been varied definitions in the literature of renal functional benefit after renal artery stent placement, with most reports relying on an absolute value of the change in serum creatinine ("binary or dichotomous outcome") as the parameter for success. In this model, the absolute value of GFR after treatment is used to construct thresholds, which define discrete reporting of outcomes, ie, "failure" or "benefit." However, although such absolute binary determinations may be used in assessing renal function, it is important to recognize that the impact of intervention may be manifested not only by a change in the absolute value of GFR but also as stabilization or slowed decline in previously diminishing GFR.153-157⇓⇓⇓⇓ In other words, the trend in renal function over time may provide an equally valid and valuable assessment of treatment effect as the absolute measure of renal function at discrete time points after intervention. Hence, renal function benefit may be evaluated by both ...
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Chest X-Ray to evaluate cardiac size; echocardiogram to assess valves and ejection fraction as well as LVH; bloodwork includes a basic chemistry to asses for electrolytes and creatinine; 24 hours fractionated urinary metanephrines and cathecolamines; renal ultrasound; nuclear imaging of kidneys with Lasix to assess renal function; MRA of renal arteries as a non invasive approach to renovascular hypertension ...
I have had uncontrolled hypertension for 18 months now, despite being on Antenolol w/ diuretic and Clonidine .2 mg/1per day, plus trying all the different types of bp meds that didnt work. I went to the dr for something unrelated and my bp was 155/115, so he suggested a renal artery scan. I showed some blockage in one of my arteries. I went to a surgeon for follow up and she suggested a renal bypass. She said since I am young, 27, that I would outlive a stint and therefore wanted to do something more permanent. Im getting a second opinion in a few weeks ...
In most cases it is possible to trace the artery back to its anastomosis with the iliac artery, using colour Doppler. If the site of the stenosis is identified, spectral Doppler will demonstrate an increase in peak systolic velocity at the lesion, followed by poststenotic turbulence (Fig. ultrasound images below). This can be difficult to pinpoint with MRA, especially if bowel is overlying the vessel. A delayed systolic rise (the parvus tardus waveform) can be identified in the intrarenal spectral Doppler waveforms, as for the native kidney (see above). The diagnosis however is primarily made on the peak systolic velocity within the renal artery. A value of , 2.5 m/s is normal while , 2.5 m/s constitutes RAS. If the stenosis is severe, it may be difficult to identify colour flow in the kidney and the waveform may be reduced in velocity with a tiny, damped trace in the main vessel. A stenosis affecting an interlobar artery may result in focal, segmental changes in the kidney. In general, contrast ...
Before reaching the hilus of the kidney, each artery divides into four or five branches; the greater number of these (anterior branches) lie between the renal vein and ureter, the vein being in front, the ureter behind, but one or more branches (posterior branches) are usually situated behind the ureter. Each vessel gives off some small inferior suprarenal branches to the suprarenal gland, the ureter, and the surrounding cellular tissue and muscles. One or two accessory renal arteries are frequently found, especially on the left side since they usually arise from the aorta, and may come off above (more common) or below the main artery. Instead of entering the kidney at the hilus, they usually pierce the upper or lower part of the organ. ...
The purpose of this study was to gain more information on the structure of different layers of renal arteryand comparing these structures in post-natal male and female sheep. To do so, right and left renal arteries of6 adult and 6 newborn animals were dissected; the middle parts of arteries were only collected. After tissueprocessing using paraffin embedding method, 5-6-μm sections were cut and stained with haematoxylin andeosin, green Massons trichrome and Verhoeffs elastic fiber methods. Three layers were identified in thewall of artery in both sexes. In tunica media the number of rows of circular smooth muscle cells was 15-25rows in newborn and 30-40 in adult sheep. External elastic membrane was visible in adult and wasstructurally thinner than the internal membrane. Tunica adventitia was visible in all samples and collagenfibers and smooth muscles bundle were distinguished. The existence of these muscle bundles in externallayer of renal artery was not reported previously in domestic animals and
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ABSTRACT The peculiarity of renal vascular variations challenges the surgeons and interventional radiologists with the task of defining the singular pattern of origin and entry of arteries into the kidney. Presence of multiple renal arteries is a perplexing predicament for the surgeon during interventional procedures as there are uncertainties about the future outcome. The present study reports a variant renal vasculature and aspires to emphasize its embryological basis and surgical implications. During routine cadaveric dissection, we observed three renal arteries arising separately from the abdominal aorta and entering the left kidney at the hilum. The inferior suprarenal artery emerged from the most superior renal artery while the inferior most renal artery crossed superficial to the ureter to enter the hilum. The persistence of mesonephric arteries is the culprit in most renal vascular variants as was seen in the present study. Morphometric analysis revealed the three arteries had similar ...
Patient History. An 83-year-old patient presents with chronic angina and difficult to control hypertension. In spite of 3 different antihypertensive medications, her blood pressure is consistently over 180/90. Noninvasive testing suggested right renal artery stenosis.. Methods. We went in the right groin and used a Jr4 diagnostic catheter for a renal angiogram. The right renal artery was 80% stenosed (Video 1). We passed a .014" Cougar wire (Medtronic) and predilated the stenosis with a 3.5 AngioScore balloon (Spectranetics,). We then passed a 5.0mm x 18mm Herculink stent (Abbott) (Video 2). We then passed the Flash Ostial balloon system (Cardinal Health) 5.0mm x 14mm. We passed the middle marker of the balloon 2mm inside of the stent ostium (Video 3). The proximal Flash balloon was dilated twice to large diameter (Video 4). The resultant residual was minimal and there was excellent proximal flaring of the stent (Videos 5 and 6). Discussion. Renal artery stenting is still controversial; however, ...
Feasibility of renal artery stenting before, during, and after endovascular aneurysm repair with suprarenal fixation endograft.: Suprarenal fixation by means of
Left renal artery aka Arteria renalis sinistra in the latin terminology and part of arteries of the small intestine with focus on the superior mesenteric artery. Learn more now!
If patients could recognise themselves, or anyone else could recognise a patient from your description, please obtain the patients written consent to publication and send them to the editorial office before submitting your response [Patient consent forms] ...
The left renal artery passes laterally from the abdominal aorta into the left kidney. It then divides into several smaller branches within the kidney tissues.
Renal angiography, the standard diagnostic procedure used to confirm the presence of renal artery stenosis before surgery or angioplasty, is associated with renal complications that include renal failure. Consequently, alternative but accurate screening procedures with minimal adverse effects have been sought. Captopril renal scans have shown promise toward achieving this goal (1). A recent prospective study showed that patients with captopril-induced changes during preoperative scintigraphy had marked improvement in blood pressure control after revascularization (2). Preoperative scintigraphy, however, is operator-dependent, resulting in greater sensitivity and specificity in some academic centers than in community hospitals. The study by Olin and colleagues shows that duplex ultrasound scanning can have a sensitivity and a specificity of , 95% for detecting renal arterial lesions. Although this is impressive, it should be noted that these data were derived from a group of persons with severe ...
Retrograde cannulation of the left renal artery with a 4 Fr JR catheter; injection of contrast medium through the catheter confirming the successful reenterin
... : abdomen: arteries (L1 (lumbar), T12, (x paired visceral arteries, v paired visceral arteries), (v paired parietal arteries, x paired parietal arteries), abdominal aorta, L2 (lumbar), L3 (lumbar), L5 (lumbar), L4 (lumbar), )
The right interlobar artery is not visible, because it is not surrounded by aerated lung but by the collapsed lower lobe, which is adjacent to the right atrium.. On a follow-up chest film the atelectasis has resolved. We assume that the atelectasis was a result of post-traumatic poor ventilation with mucus plugging.. Notice the reappearance of the right interlobar artery (red arrow) and the normal right heart border (blue arrow).. ...
Renal arteries are very essential for the kidney as the major function of these arteries is to provide blood to the kidneys. Renal arteries are present above the renal veins. There may be two or more than two arteries serving each kidney. The arteries present in the kidney are the pair of large blood vessel Read more ...
Open Abdominal Procedures Used to Treat the Following: AAAs (Abdominal Aortic Aneurysms) TAAs (Thoracic Aortic Aneurysms) TAAAs (Thorocoabdominal Aortic Aneurysms Renal Artery Aneurysms Renal Artery Stenosis or Renovascular Hypertension Aortoilliac Occlusion Superior Mesenteric Artery Stenosis Removal of Infected Graft
Dr. Mark Allen offers diagnostics, treatment and follow-up care for urological disorders. A renal angiography is used to diagnose kidney disorders.
OBJECTIVE to prevent kidney injury in renal artery and juxta-renal aortic surgery. After 30 min of cross-clamping ischaemia, renal arterial inflow is temporary re-established for 3 min. The aim of the study was to retrospectively analyse the results of this original technique. METHODS between January 1987 and May 1999, 48 patients underwent kidney short-term arterial blood reperfusion, directly or through the Pruitt-Inahara shunt. The reperfusion was repeated every 30 min of ischaemia, whenever necessary. Fifty control patients underwent |30 min of kidney ischaemia. Patients were assessed by serum creatinine, digital angiography and radioisotope renography using technecium(99). RESULTS in the study group one patient developed an acute renal failure and died (2% (-95% CI: 0-11%)). In both study and control groups patients showed a similar and moderate but temporary decline in renal function, which returned to preoperative levels after 1 week. CONCLUSIONS the results of this study indicate that
Angioplasty with stenting (1-2 stent) in stenosis of a renal artery (costs for program #178141) ✔ University Hospital Rechts der Isar of the Munich Technical University ✔ Department of Vascular Surgery ✔ BookingHealth.com
Angioplasty with stenting (1-2 stent) in stenosis of a renal artery (costs for program #227363) ✔ University Hospital Würzburg ✔ Department of Thoracic and Cardiovascular Surgery ✔ BookingHealth.com
Diagnosis Code S35.491S information, including descriptions, synonyms, code edits, diagnostic related groups, ICD-9 conversion and references to the diseases index.
A = interlobar arteries and veins B = renal artery C = renal vein D = ureter E = renal pyramids F = minor calyx G = major calyx H = renal pelvis I = capsule J = medulla K = cortex L = nephrons ...
1. An improved method of aorto-renal reconstruction in renal artery stenosis is described.. 2. The Dacron prosthesis is inserted high in the aorta, thus avoiding a recurrent course and limiting turbulence.. 3. The prosthesis is inserted end-to-end in the reconstructed renal artery.. 4. On the right side the restructured renal artery is placed anterior to the vena cava.. 5. These modifications result in a wide anastomosis with maximum haemodynamic effectiveness.. ...