Renal Artery Stenosis After Abdominal Aortic Aneurysm Interventional Treatment in a Patient With Systemic Atherosclerosis

2016 ◽  
Vol 23 (6) ◽  
pp. e1922-e1924
Author(s):  
Yonghua Xu ◽  
Chuanwei Zhou ◽  
Surong Jiang ◽  
Di Xu ◽  
Yan Guo ◽  
...  
Keyword(s):  
Abdominal Aortic Aneurysm ◽  
Aortic Aneurysm ◽  
Renal Artery ◽  
Renal Artery Stenosis ◽  
Artery Stenosis ◽  
Interventional Treatment ◽  
Abdominal Aortic

scholarly journals Renal artery stenosis due to abdominal aortic aneurysm.

1968 ◽  
Vol 44 (518) ◽  
pp. 928-930 ◽  
Author(s):  
M. N. Lowenthal ◽  
S. A. Doctor ◽  
J. Fine
Keyword(s):  
Abdominal Aortic Aneurysm ◽  
Aortic Aneurysm ◽  
Renal Artery ◽  
Renal Artery Stenosis ◽  
Artery Stenosis ◽  
Abdominal Aortic

Renal Artery Stenosis and Renal Parenchymal Damage in Patients with Abdominal Aortic Aneurysm Proven by Autopsy

2009 ◽  
Vol 32 (1) ◽  
pp. 11-16 ◽  
Author(s):  
Satoko Nakamura ◽  
Hatsue Ishibashi-Ueda ◽  
Chigure Suzuki ◽  
Hiroto Nakata ◽  
Fumiki Yoshihara ◽  
...  
Keyword(s):  
Abdominal Aortic Aneurysm ◽  
Aortic Aneurysm ◽  
Renal Artery ◽  
Renal Artery Stenosis ◽  
Artery Stenosis ◽  
Abdominal Aortic ◽  
Parenchymal Damage

scholarly journals A clinicopathologic evaluation of renal artery stenosis with abdominal aortic aneurysm

2008 ◽  
Vol 28 (6) ◽  
pp. 543-547
Author(s):  
Jun Shimizua ◽  
Akihito Inatsu ◽  
Satoshi Oshima ◽  
Eiichi Shimizu ◽  
Takao Kubota ◽  
...  
Keyword(s):  
Abdominal Aortic Aneurysm ◽  
Aortic Aneurysm ◽  
Renal Artery ◽  
Renal Artery Stenosis ◽  
Artery Stenosis ◽  
Abdominal Aortic

scholarly journals "Flash" pulmonary oedema as a clinical manifestation of renovascular hypertension

2003 ◽  
Vol 131 (5-6) ◽  
pp. 208-210 ◽  
Author(s):  
Dimitra Kalimanovska-Ostric ◽  
Branislava Ivanovic ◽  
Vladimir Ostric ◽  
Vesna Knezevic ◽  
Vesna Stojanov ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Abdominal Aortic Aneurysm ◽  
Renal Artery ◽  
Pulmonary Oedema ◽  
Renal Artery Stenosis ◽  
Left Ventricular ◽  
Artery Stenosis ◽  
Atherosclerotic Renal Artery Stenosis ◽  
Renal Revascularization ◽  
Abdominal Aortic

One of the clinical manifestations of renovascular hypertenzion (RVH) may be a recurrent pulmonary oedema both in the absence or in the presence of systolic left ventricular dysfunction. This type of pulmonary oedema characterized as "flash" pulmonary oedema is ascribed to elevated angiotensin II concentrations with consequent hypertension as well as to volume overload resulting from decreased pressure natriuresis when there are significant stenoses of both or one renal arteries. The investigation included 30 patients with RVH treated by percutaneous transluminal angioplasty of the stenosed renal artery (PTRA) and/or stent implantation (PTR-ST) and 30 patients with surgical resection of the abdominal aortic aneurysm (AAA). The first group was divided in two subgroups according to the etiology of renal artery stenosis (RAS). In the subgroup with fibromuscular dysplasia (FMD) the mean age was 37.5 years, in the subgroup with atherosclerotic renal artery stenosis (ARAS) 54.8 years and in the group with operated AAA 68.6 years. There were more females than males only in the FMD subgroup (10:3). Two patients of the first group experienced pulmonary oedema, both in the subgroup with atherosclerotic renal artery stenosis associated with atherosclerosis of other arteries. Normalization of the blood pressure following PTRA in both and an uncomplicated course after a surgical myocardial revascularization in one of them illustrates the importance of renal revascularization. Pulmonary oedema occurred preoperatively in four out of 30 patients with abdominal aortic aneurysm in whom significant renal artery stenoses coexisted. Two patients died despite surgery, one patient is clinically stable and the medicament treatment of heart failure is inevitable in the fourth with a left ventricular aneurysm following myocardial infarction. The occurrence or reoccurrence of pulmonary oedema in the absence of other explanation should suggest the possibilty of billateral or unilateral renal artery stenosis requiring renal revascularization for blood pressure regulation as well as for elimination of other manifestations/complications.

scholarly journals Ex vivo repair of renal artery aneurysm associated with surgical treatment of abdominal aortic aneurysm

2004 ◽  
Vol 132 (7-8) ◽  
pp. 250-253
Author(s):  
Dusan Kostic ◽  
Lazar Davidovic ◽  
Drago Milutinovic ◽  
Radomir Sindjelic ◽  
Marko Dragas ◽  
...  
Keyword(s):  
Abdominal Aortic Aneurysm ◽  
Aortic Aneurysm ◽  
Renal Artery ◽  
Ex Vivo ◽  
Artery Aneurysm ◽  
Ptfe Graft ◽  
Dacron Graft ◽  
Renal Artery Aneurysm ◽  
Abdominal Aortic ◽  
The Right

INTRODUCTION Renal artery aneurysms is relatively uncommon with reported incidence ranges from 0.3% to 1%. However, considering all visceral artery aneurysms the percentage of renal artery aneurysms is relatively high between 15-25%. The distal forms of renal artery aneurysms sometimes require "ex vivo" reconstruction and kidney autotransplantation. CASE REPORT A 75-year-old male presented with the right abdominal and back pain. He suffered from a long history of arterial hypertension and chronic renal failure over the last few months (urea blood = 19.8 mmol/l; creatinine = 198 mmol/l). Duplex ultrasonography showed abdominal aortic aneurysm. Subsequent translumbarangiography revealed juxtarenal abdominal aortic aneurysm associated with distal right renal artery aneurysm. The operation was performed under combined thoracic epidural analgesia and general anesthesia using transperitoneal approach. After the laparotomy, the ascending colon was mobilized and reflected medially followed by Kocher maneuver. The result was visualization of the anterior aspect of the right kidney, the collecting system, ureter as well as the right renal vein and artery with large saccular aneurysm located distally. After mobilization of the renal vessels and careful dissection of the ureter, the kidney was explanted. The operation was continued by two surgical teams. The first team performed abdominal aortic aneurysm resection and reconstruction with bifurcated Dacron graft. The second team performed ex vivo reparation of renal artery aneurysm. All time during the explantation, the kidney was perfused by Collins' solution. The saccular right renal artery aneurysm 4 cm in diameter was located at the kidney hilus at the first bifurcation. Three branches originated from the aneurysm. The aneurysm was resected completely. The longest and widest of three branches arising from the aneurysmal sac was end-to-end anastomized with 6 mm PTFE graft. After this intervention, one of shorter arteries was implanted into the long artery, and another one into PTFE graft. After 30 minutes of explanation, autotransplantation of the kidney into the right iliac fossa was performed. The right renal vein was implanted into the inferior vein cava, and PTFE graft into the right limb of Dacron graft. Immediately following the completion of both anastomoses, large volume of urine was evident. Finally, ureteneocystostomy was performed with previous insertion of double "J" catheter. In the immediate postoperative period, renal function was restored to normal, while postoperative angiography revealed all patent grafts. DISCUSSION The most common causes of renal artery aneurysms are arteriosclerosis, as in our case, and fibro-muscular dysplasia. Very often, renal artery aneurysms are asymptomatic and discovered only during angiography in patients with aneurysmal and occlusive aortic disease. Other cases include: arterial hypertension, groin pain and acute or chronic renal failure. Due to relatively small number of evaluated cases, the risk of aneurysmal rupture is not known. According to some authors, the overall rupture rate of renal artery aneurysm is 5%, however, the rupture risk becomes higher in young pregnant woman. Several standard surgical procedures are available for the repair of renal artery aneurysms. These include saphenous vein angioplasty, bypass grafting, as well as ex vivo reconstruction with reimplantation or autotransplantation. Furthermore, interventional embolization therapy, as well as endovascular treatment with ePTFE covered stent, or autologous vein-coverage stent graft, have been also reported to be successful. CONCLUSION The major indications for surgical treatment of renal artery aneurysms are to eliminate the source of thromboembolism which leads to fixed renal hypertension and kidney failure, as well as prevention of aneurysmal rupture.

Sign in / Sign up

Export Citation Format

Share Document