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Case studies: urgent decisions in interventional radiology
Published in William H. Bush, Karl N. Krecke, Bernard F. King, Michael A. Bettmann, Radiology Life Support (Rad-LS), 2017
The patient underwent a diagnostic arteriogram using the right percutaneous femoral approach. The aortogram showed a tight left renal artery stenosis. A 7-Fr. sheath was placed in the right groin, the renal artery lesion was crossed with a steerable guidewire, 5000 units of heparin were administered and the lesion was dilated and stented with a 1.5-cm-length × 6-mm-diameter stent. Following the procedure, the catheter and guidewire were removed. The activated clotting time (ACT) was measured and the initial reading was 225 s. On remeasurement 90 min later, the ACT had decreased to a level of 160 s and the sheath was removed without incident. A small hematoma was noted prior to the patient’s discharge. The next day, the patient called to say that she had no bleeding or other problems, her blood pressure was normal on no medication, but that she had a swelling in her groin at the site of the arterial puncture which was pulsatile and slightly tender. She thought that it was larger than it had been at the time of discharge.
Cardiovascular system
Published in David A Lisle, Imaging for Students, 2012
Where the screening tests are positive, renal angiography and interventional radiology are indicated. Most patients with renal artery stenosis are treated with interventional radiology, i.e. percutaneous transluminal angioplasty (PTA) and stent insertion. The goals of treatment with interventional radiology are normal blood pressure, or hypertension that can be controlled medically plus improved renal function.
Urinary system
Published in A Stewart Whitley, Jan Dodgeon, Angela Meadows, Jane Cullingworth, Ken Holmes, Marcus Jackson, Graham Hoadley, Randeep Kumar Kulshrestha, Clark’s Procedures in Diagnostic Imaging: A System-Based Approach, 2020
A Stewart Whitley, Jan Dodgeon, Angela Meadows, Jane Cullingworth, Ken Holmes, Marcus Jackson, Graham Hoadley, Randeep Kumar Kulshrestha
Renal artery stenosis may be caused by a variety of conditions, such as fibromuscular dysplasia or atherosclerotic disease. With transplant kidneys, a stenosis may form in the artery (Figs 7.15c,d) or vein, usually at or close to the site of the anastomosis.
Influence of renal artery stenosis morphology on hemodynamics
Published in Computer Methods in Biomechanics and Biomedical Engineering, 2021
Zhuxiang Xiong, Ding Yuan, Jiarong Wang, Tinghui Zheng, Yubo Fan
Renal artery stenosis (RAS) is a major cause of secondary hypertension and can lead to drug-resistant (refractory) hypertension, a progressive decline in renal function, and cardiac instability syndromes (pulmonary edema, recurrent heart failure, or acute coronary syndromes) (Gupta et al. 2019; Prince et al. 2019), despite directed drug therapy. Therefore, timely and effective diagnosis and treatment of RAS are considerably very important.