Improved Technique for Aorto-Renal Reconstruction: A Haemodynamic Approach

1973 ◽  
Vol 45 (s1) ◽  
pp. 315s-316s
Author(s):  
U. Ruberti ◽  
A. Vegeto ◽  
E. Malan
Keyword(s):  
Renal Artery ◽  
Renal Artery Stenosis ◽  
Vena Cava ◽  
Artery Stenosis ◽  
Improved Method ◽  
End To End ◽  
Renal Reconstruction ◽  
The Right ◽  
Improved Technique

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.

scholarly journals Renal artery stenosis of atherosclerotic etiology – the single kidney surgical recurrence 12 years after nephrectomy

2016 ◽  
Vol 63 (3) ◽  
pp. 251-254
Author(s):  
Maria Daniela Tănăsescu ◽  
◽  
Marcel Pălămar ◽  
Mihai Ovidiu Comşa ◽  
Alexandru Mincă ◽  
...  
Keyword(s):  
Renal Artery ◽  
Renal Artery Stenosis ◽  
Left Kidney ◽  
Secondary Hypertension ◽  
Artery Stenosis ◽  
The Other ◽  
Left Renal Artery ◽  
Arterial Blood ◽  
The Moment ◽  
The Right

Objectives. Renal artery stenosis, as main cause of renovascular secondary hypertension, is mainly caused by atherosclerosis of large vessels and is clinically characterized by resistant or malignant hypertension, impacting the kidney function to various degrees. The present article brings into attention the case of a patient which developed renal artery stenosis on the left kidney, the same condition occurring 12 years later on the right kidney. Material and method. Our patient was initially diagnosed at the age of 48 with complete occlusion of the left renal artery, for which left nephrectomy was performed, while the right artery was normal. Twelve years later she presents with renal artery stenosis on the right kidney, which is treat by stent-angioplasty. Results. After surgery, the patient’s evolution was positive, with amelioration of the laboratory values, in parallel to the arterial blood pressure. Discussions. The probability that, in the moment of diagnosis of renal artery stenosis with progressive evolution to occlusion caused by atherosclerosis, the other artery would be normal, both seen by ultrasonography and angiography, while years later to develop stenosis, is minimal. Up to present, the literature holds little evidence of such similar cases. Conclusions. In the particular case of patients that were diagnosed with severe renal artery stenosis of atherosclerotic origin and had only one of the arteries affected, it is necessary to keep a permanent monitoring, justified by the risk of development of the same pathology to the other artery

Use of shockwave intravascular lithotripsy for the treatment of calcified renal artery stenosis in a symptomatic subject

2020 ◽  
Vol 16 (5) ◽  
pp. 419-423
Author(s):  
S Schnupp ◽  
I Ajmi ◽  
M Sinani ◽  
J Brachmann ◽  
C Mahnkopf
Keyword(s):  
Renal Artery ◽  
Renal Artery Stenosis ◽  
Artery Stenosis ◽  
Left Renal Artery ◽  
Shockwave Lithotripsy ◽  
Refractory Hypertension ◽  
Atherosclerotic Renal Artery Stenosis ◽  
Wall Apposition ◽  
The Right ◽  
Symptomatic Subject

Aim: The use of shockwave lithotripsy for the treatment of heavily calcified atherosclerotic plaques before stenting showed great results in terms of feasibility and safety with favorable initial success. Evidence suggests that it is a useful tool to treat calcified lesions in peripheral and coronary arteries. Here, we describe the case of a patient with calcified renal artery stenosis successfully treated with the shockwave lithotripsy system. Case Report: We present a 76-year-old man with a known significant atherosclerotic renal artery stenosis and refractory hypertension. The patient received an angioplasty of the right renal artery in the first session and he was admitted for a second session to intervene in the left renal artery. The lesion was successfully treated with the lithotripsy system. Final angiography demonstrated an excellent position of the stent and good wall apposition. Conclusion: Our clinical case demonstrates that lithotripsy is safe and effective also for the treatment of the renal artery.

Experimental Analysis of Transvenous Ultrasonography in Localizing and Grading Renal Artery Stenosis

Vascular ◽  
2004 ◽  
Vol 12 (5) ◽  
pp. 301-306
Author(s):  
Albeir Mousa ◽  
Joshua Bernheim ◽  
Rajeev Dayal ◽  
Jonathan Deitch ◽  
Peter Henderson ◽  
...  
Keyword(s):  
Renal Artery ◽  
Renal Artery Stenosis ◽  
Effective Means ◽  
Vena Cava ◽  
The United States ◽  
Renal Arteries ◽  
Artery Stenosis ◽  
Model Study ◽  
Animal Model Study ◽  
Stenotic Lesions

This study evaluated the potential for transvenous ultrasonography to assess renal artery stenosis (RAS), the most common correctable cause of hypertension in the United States. We developed a porcine model for studying RAS using TVUS. An endovascular ultrasound probe was placed into the inferior vena cava and renal veins to image renal arteries in which stenoses had been surgically created in varied locations and to varied degrees. TVUS was then used to identify and assess these stenotic lesions. The accuracy of TVUS for determining the degree and location of the stenoses was then determined using contrast arteriography as the standard. When compared with arteriography, TVUS identified and properly located all six lesions and correctly quantified the degree of stenosis in five of the six lesions. TVUS is an effective means of assessing the presence, degree, and location of stenotic lesions of the renal arteries in this animal model. Study of this method in humans may be warranted.

scholarly journals Low-Energy Shockwave Treatment Promotes Endothelial Progenitor Cell Homing to the Stenotic Pig Kidney

2020 ◽  
Vol 29 ◽  
pp. 096368972091734 ◽  
Author(s):  
Yu Zhao ◽  
Adrian Santelli ◽  
Xiang-Yang Zhu ◽  
Xin Zhang ◽  
John R. Woollard ◽  
...  
Keyword(s):  
Renal Artery ◽  
Renal Artery Stenosis ◽  
Ex Vivo ◽  
Vena Cava ◽  
Underlying Mechanism ◽  
Low Energy ◽  
Artery Stenosis ◽  
Endothelial Progenitor ◽  
Atherosclerotic Renal Artery Stenosis ◽  
Urinary Levels

Endothelial progenitor cells (EPCs) patrols the circulation and contributes to endothelial cell regeneration. Atherosclerotic renal artery stenosis (ARAS) induces microvascular loss in the stenotic kidney (STK). Low-energy shockwave therapy (SW) can induce angiogenesis and restore the STK microcirculation, but the underlying mechanism remains unclear. We tested the hypothesis that SW increases EPC homing to the swine STK, associated with capillary regeneration. Normal pigs and pigs after 3 wk of renal artery stenosis were treated with six sessions of low-energy SW (biweekly for three consecutive weeks) or left untreated. Four weeks after completion of treatment, we assessed EPC (CD34+/KDR+) numbers and levels of the homing-factor stromal cell-derived factor (SDF)-1 in the inferior vena cava and the STK vein and artery, as well as urinary levels of vascular endothelial growth factor (VEGF) and integrin-1β. Subsequently, we assessed STK morphology, capillary count, and expression of the proangiogenic growth factors angiopoietin-1, VEGF, and endothelial nitric oxide synthase ex vivo. A 3-wk low-energy SW regimen improved STK structure, capillary count, and function in ARAS+SW, and EPC numbers and gradients across the STK decreased. Plasma SDF-1 and renal expression of angiogenic factors were increased in ARAS+SW, and urinary levels of VEGF and integrin-1β tended to rise during the SW regimen. In conclusion, SW improves ischemic kidney capillary density, which is associated with, and may be at least in part mediated by, promoting EPCs mobilization and homing to the stenotic kidney.

Uptake of Inactive Renin by Human Ischaemic Kidney

1983 ◽  
Vol 65 (1) ◽  
pp. 27-32 ◽  
Author(s):  
I. M. McKenzie ◽  
E. Reisin ◽  
J. K. McKenzie
Keyword(s):  
Essential Hypertension ◽  
Renal Artery ◽  
Renal Artery Stenosis ◽  
Peripheral Blood ◽  
Renal Vein ◽  
Vena Cava ◽  
Artery Stenosis ◽  
Renal Ischaemia ◽  
Active Renin ◽  
Inactive Renin

1. Plasma samples from both renal veins and infrarenal inferior vena cava were studied in 21 patients with unilateral renal artery stenosis and 11 patients without significant renal artery stenosis (essential hypertension), both groups being on unrestricted sodium intake. 2. Whether inactive renin was activated by acid or trypsin, it tended to be increased by 50–100% in unilateral renal ischaemia patients compared with essential hypertension. Active renin was increased two- to four-fold in unilateral renal ischaemia patients compared with those with essential hypertension. Thus the ratio of active to total renin in peripheral venous blood tended to be higher in unilateral renal ischaemia (0.37) than in essential hypertension (0.30) patients. 3. in renal vein blood from the affected kidney in unilateral renal ischaemia, the proportion of active renin to total renin was very high (68% for trypsinized samples and 73% for acidified samples). When affected renal vein blood was compared with infrarenal vena caval blood (equivalent to renal artery blood in amount and proportions of active and inactive renin), there was found to be a marked increase of active renin (ratio 2.83, significance of difference from 1.0, P < 0.001), as expected. 4. Inactive renin was decreased in affected renal vein blood compared with peripheral blood (ratio of renal vein to peripheral blood renin). This occurred whether acidification was used (ratio 0.62 ±0.11, P < 0.01) or trypsin (ratio 0.70 ± 0.13, P < 0.05). 5. The cause of the apparent uptake may be conversion of inactive renin into active renin by protease action in the ischaemic kidney. Urinary excretion or lymphatic drainage would seem unlikely.

Sign in / Sign up

Export Citation Format

Share Document