Intraluminal Dilatation of Renal Artery Stenosis

1979 ◽  
Vol 57 (s5) ◽  
pp. 441s-443s ◽  
Author(s):  
G. G. Geyskes ◽  
C. B. A. J. Puylaert ◽  
H. Y. Oei ◽  
J. H. B. Boomsma
Keyword(s):  
Blood Pressure ◽  
Blood Flow ◽  
Renal Artery ◽  
Renal Artery Stenosis ◽  
Local Anaesthesia ◽  
Balloon Catheter ◽  
Artery Stenosis ◽  
Temporary Increase ◽  
Rapid Procedure ◽  
Promising Treatment

1. In 13 patients with hypertension and renal artery stenosis the stenosis was dilated by an intra-arterial balloon catheter under local anaesthesia. 2. In all but one instance arteriography after the dilatation showed considerable widening of the stenosed area. 3. Six patients had a temporary increase of serum creatinine that lasted only a few days. 4. In seven patients, who had a prolonged transit time at renography, this marker of renal blood flow improved after the dilatation. 5. The effect of the dilatation on the blood pressure in this group of patients, selected on arteriographic criteria only, was variable, but comparable with results of renovascular surgery. 6. Dilatation of renal artery stenosis by an intra-arterial balloon catheter is a promising treatment for patients with hypertension and renal artery stenosis. It is a rapid procedure needing only local anaesthesia. Complications in our experience so far are minor.

scholarly journals Clinical response scores to predict blood pressure and renal function improvement following renal artery stenting for atherosclerotic renal artery stenosis

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
A Kablak-Ziembicka ◽  
A Roslawiecka ◽  
R Badacz ◽  
A Sokolowski ◽  
P Musialek ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Logistic Regression ◽  
Renal Function ◽  
Renal Artery ◽  
Renal Artery Stenosis ◽  
Predictive Models ◽  
Artery Stenosis ◽  
Atherosclerotic Renal Artery Stenosis ◽  
Baseline Serum ◽  
Kidney Length

Abstract Background It is little known about predictors of systolic (SBP) and diastolic (DBP) blood pressure or renal function (eGFR) improvement in patients with atherosclerotic renal artery stenosis (ARAS) undergoing stent-assisted angioplasty (PTA). Therefore, we aimed to build a prediction scores that would indicate characteristics of patient subsets with ARAS most likely to have clinical improvement following PTA. Methods 201 patients who underwent PTA for ARAS (2003–2018) were categorized as eGFR or SBP/DBP responders based on eGFR increase of ≥11 ml/min/1.73m2, decrease of SBP ≥20mmHg and DBP ≥5mmHg at 12-months following PTA. The remaining patients were classified as non-responders. The performance of logistic regression models were evaluated by basic decision characteristics. Continuous data have been transformed into binary coding with help of operating characteristic (ROC) curve. Predictive models have been constructed for each followed by construction of predictive models in each of 3 categories. Results Logistic regression analysis showed that: baseline SBP>145 mmHg, DBP >82 mmHg, previous myocardial infarction and Renal-Aotric-Ratio >5.1 were independent influencing factors of SBP response, with relative risk percentage shares of 69.8%; 12.1%; 10.9%; and 7.2%, respectively (sensitivity: 82%, specificity: 86.3%, positive (PPV):82% and negative (NPV) predictive values: 86.3%). The DBP decrease prediction model included baseline SBP >145 mmHg and DBP >82 mmHg, the ARAS progression, index kidney length >106 mm, and bilateral PTA with respective shares of 35.0%; 21.8%; 18.2%; 13.3% and 11.8%. (sensitivity: 76%, specificity: 77.8%, PPV: 80.7% and NPV: 72.6%). The eGFR increase was associated with baseline serum creatinine >122 μmol/L but eGFR greater than 30 ml/min/1.73m2, index kidney length >98 mm, end-diastolic velocity in index renal artery, renal resistive index <0.74, and requirement for >3 BP medications, with respective shares of 24.4%; 24.4%; 21.2%; 15% and 15% (sensitivity: 33.3%, specificity: 93.5%, PPV: 65.6% and NPV: 78.9%). Conclusions Current study identified clinical characteristics of patients who most likely to respond to PTA for ARAS. The sutability of the score should be verified in a prospective cohort of patients referred to PTA of ARAS Funding Acknowledgement Type of funding source: None

scholarly journals Preserved Oxygenation Despite Reduced Blood Flow in Poststenotic Kidneys in Human Atherosclerotic Renal Artery Stenosis

Hypertension ◽  
2010 ◽  
Vol 55 (4) ◽  
pp. 961-966 ◽  
Author(s):  
Monika L. Gloviczki ◽  
James F. Glockner ◽  
Lilach O. Lerman ◽  
Michael A. McKusick ◽  
Sanjay Misra ◽  
...  
Keyword(s):  
Blood Flow ◽  
Renal Artery ◽  
Renal Artery Stenosis ◽  
Artery Stenosis ◽  
Atherosclerotic Renal Artery Stenosis

Abstract 9839: Beta Blockers Improve Renal Tissue Oxygenation in Hypertensive Patients Suspected of Renal Artery Stenosis

Circulation ◽  
2015 ◽  
Vol 132 (suppl_3) ◽  
Author(s):  
Michael E Hall ◽  
Michael V Rocco ◽  
Timothy M Morgan ◽  
Craig A Hamilton ◽  
Jennifer H Jordan ◽  
...  
Keyword(s):  
Blood Flow ◽  
Renal Artery ◽  
Renal Artery Stenosis ◽  
Beta Blocker ◽  
Tissue Oxygenation ◽  
Beta Blockers ◽  
Renal Tissue ◽  
Artery Stenosis ◽  
Blocker Therapy ◽  
Hypertensive Patients

Background: Chronic renal hypoxia influences the progression of chronic kidney disease (CKD). Blood oxygen level dependent (BOLD) magnetic resonance (MR) is a noninvasive tool for assessment of renal tissue oxygenation. Beta blockers reduce cardiovascular mortality in patients with CKD and systolic heart failure, however the mechanisms of this benefit remain unclear. We sought to determine the association between beta blocker use, renal cortical and medullary oxygenation, and renal blood flow in hypertensive patients suspected of renal artery stenosis. Hypothesis: Chronic receipt of beta blockers will be associated with improved renal tissue oxygenation as assessed by BOLD MR. Methods: We measured renal cortical and medullary oxygenation using BOLD MR and renal artery blood flow using MR phase contrast techniques in 38 participants suspected of renal artery stenosis. Results: Chronic beta blocker therapy was associated with improved renal cortical (p=0.0007) and medullary (p=0.03) oxygenation (Figure). Receipt of angiotensin converting enzyme inhibitors or angiotensin receptor blockers was associated with reduced medullary oxygenation (p=0.01). In a multivariable model including gender, hemoglobin, diabetes, loop diuretic use, and mineralocorticoid use, chronic receipt of beta blockers was the only significant predictor of renal tissue oxygenation (β= 8.4, p=0.008). Conclusions: Beta blocker therapy was associated with improved renal oxygenation independent of renal blood flow suggesting may these findings may be related to reduced renal oxygen consumption. In addition to their known benefits to reduce cardiovascular mortality in patients with renal disease, beta blockers may reduce or prevent progression of renal dysfunction in patients with hypertension, diabetes, and renovascular disease. These observations may have important implications for treatment of patients with CKD.

Abstract 1785: Renal Artery Angioplasty Improves Diastolic Cardiac Function In Patients With heart failure Possessing Renal Artery Stenosis.

Circulation ◽  
2007 ◽  
Vol 116 (suppl_16) ◽  
Author(s):  
Eisei Yamamoto ◽  
Hitoshi Takano ◽  
Hiroyuki Tajima ◽  
Jun Tanabe ◽  
Hidekazu Kawanaka ◽  
...  
Keyword(s):  
Heart Failure ◽  
Blood Pressure ◽  
Blood Flow ◽  
Cardiac Function ◽  
Renal Artery ◽  
Renal Blood Flow ◽  
Renal Artery Stenosis ◽  
Arterial Blood Pressure ◽  
Arterial Blood ◽  
Diastolic Cardiac Function

Background: Renal artery stenosis (RAS) often plays an important role not only in malignant hypertension but also in sudden development of heart failure (HF) so called ‘flash pulmonary edema’ or chronic HF refractory to medical treatment. One of the possible mechanisms whereby RAS affects these unique conditions of HF is suppression of LV compliance through the complex interaction between neurohormonal systems originating from the reduction of renal blood flow. Renal artery angioplasty is expected to be an effective treatment for restoring renal blood flow in patients with RAS. The aim of the present study was whether the angioplasty can improve the impaired neurohormonal systems and diastolic cardiac function in patients with RAS. Methods: A prospective analysis was performed in 18 HF patients with RAS (age: 72±6, 3 females, NYHA I/II/III: 5/9/4) who underwent renal artery angioplasty between 2005 and 2007. Four patients with significant bilateral RAS and 3 patients with unilateral RAS in the vessel supplying a functional solitary kidney were included. We monitored the changes of biochemical and neurohormonal markers and blood pressure. Cardiac function was evaluated by tissue Doppler echocardiogram before and 3 months after the procedure. Results: Technical success was achieved in all interventions. The results are shown in table . Systolic arterial blood pressure significantly decreased by renal angioplasty. B-type natriuretic peptide (BNP) was significantly reduced 3 months after the angioplasty, whereas the change of sCr or angiotensinII was not statistically significant. Myocardial early diastolic velocity (Em), a parameter of diastolic LV function, was significantly improved compared with that measured before the procedure. Conclusions: In patients with either overt or latent HF possessing RAS, renal artery angioplasty not only decreases arterial blood pressure but also improves diastolic cardiac function in parallel with the reduction of BNP level.

Balloon Catheter Dilatation of Renal Artery Stenosis in the Dog

1978 ◽  
Vol 4 (4) ◽  
pp. 298-302 ◽  
Author(s):  
L. Ekelund ◽  
J. Gerlock, jr. ◽  
V. Goncharenko ◽  
G. Novak
Keyword(s):  
Renal Artery ◽  
Renal Artery Stenosis ◽  
Balloon Catheter ◽  
Artery Stenosis ◽  
Catheter Dilatation
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