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Acta Radiol 2021 Jun 9:2841851211019806. Epub 2021 Jun 9.

Department of Imaging Sciences and Interventional Radiology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, Kerala, India.

Renal arteries are involved in a wide spectrum of pathologies including atherosclerosis, fibromuscular dysplasia, Takayasu arteritis, aneurysms, and aortic type B dissections extending into main renal arteries. They manifest as renovascular hypertension, renal ischemia, and cardiovascular dysfunction. The location of the renal arteries in relation to the abdominal aortic aneurysm is a critical determinant of interventional options and long-term prognosis. Read More

BMJ Case Rep 2021 May 26;14(5). Epub 2021 May 26.

Royal Prince Alfred Hospital, Camperdown, New South Wales, Australia.

Renal vascular hypertension is a diagnosis that needs to be entertained in the setting of refractory, otherwise unexplained hypertension in pregnancy. Conclusive diagnosis of the condition is made by the use of angiography, which confers only a low, safe dose of radiation to the fetus, especially after the first trimester. Percutaneous angioplasty is effective in treating this condition and is best performed postnatally to avoid fetal exposure to ionising radiation. Read More

Pediatr Nephrol 2021 Apr 13. Epub 2021 Apr 13.

Interdisciplinary Laboratory of Medical Investigation, Faculty of Medicine, Federal University of Minas Gerais (UFMG), Belo Horizonte, MG, Brazil.

Renovascular hypertension (RVH) is defined as an elevated blood pressure caused by kidney hypoperfusion, generally as a result of anatomic stenosis of the renal artery with consequent activation of the Renin Angiotensin-Aldosterone System. The main causes include genetic and inflammatory disorders, extrinsic compression, and idiopathic alterations. RVH is often asymptomatic and should be suspected in any child with refractory hypertension, especially if other suggestive findings are present, including those with severe hypertension, abdominal bruit, and abrupt fall of glomerular filtration rate after administration of angiotensin-converting enzyme inhibitors or angiotensin-receptor blockers. Read More

Life (Basel) 2021 Mar 7;11(3). Epub 2021 Mar 7.

Department of Clinical Pharmacology, Wroclaw Medical University, Wroclaw, Poland.

Renal artery stenosis (RAS) is conditioned mainly by two disturbances: fibromuscular dysplasia or atherosclerosis of the renal artery. RAS is an example of renovascular disease, with complex pathophysiology and consequences. There are multiple pathophysiological mechanisms triggered in response to significant renal artery stenosis, including disturbances within endothelin, kinin-kallikrein and sympathetic nervous systems, with angiotensin II and the renin-angiotensin-aldosterone system (RAAS) playing a central and key role in the pathogenesis of RAS. Read More

Invest Radiol 2021 Feb;56(2):86-93

From the Division of Nephrology and Hypertension.

Materials And Methods: Stenotic kidney (STK) and contralateral kidney magnetization transfer ratios (MTRs; Mt/M0) were measured at 3.0-T magnetic resonance imaging, at offset frequencies of 600 and 1000 Hz, before and 1 month post-PTRA in 7 RVD pigs. Stenotic kidney MTR was correlated to renal perfusion, renal blood flow (RBF), and glomerular filtration rate (GFR), determined using multidetector computed tomography and with ex vivo renal fibrosis (trichrome staining). Read More

Ann Vasc Surg 2021 Feb 4;71:536.e5-536.e8. Epub 2020 Nov 4.

Department of Vascular surgery, Rouen University Hospital, Rouen, France.

We present an uncommon case of a 16-year-old woman with type 1 neurofibromatosis and renovascular hypertension due to bilateral renal stenosis associated with asymptomatic digestive artery stenosis. Our patient was treated by several autologous bypasses to the superior mesenteric artery and the left and right renal arteries. She had no postoperative complications and good clinical and imaging outcomes at 10 years. Read More

Pediatr Radiol 2021 03 5;51(3):419-426. Epub 2020 Nov 5.

Edward B. Singleton Department of Radiology, Texas Children's Hospital, 6701 Fannin Street, Suite 470, Houston, TX, 77030, USA.

Background: Children with suspected renal artery stenosis (RAS) are screened with renal Doppler ultrasonography or computed tomography (CT) angiography/magnetic resonance (MR) angiography depending on institutional preference. CT angiography produces images with superior resolution, allowing higher quality multiplanar two-dimensional reformats and three-dimensional reconstructions. However, there is a paucity of data in the literature regarding the utility and diagnostic performance of renal CT angiography in pediatric RAS. Read More

Zhongguo Yi Xue Ke Xue Yuan Xue Bao 2020 Oct;42(5):691-695

Department of Vascular Surgery,PUMC Hospital,CAMS and PUMC,Beijing 100730,China.

Refractory hypertension and renal insufficiency caused by Takayasu arteritis with renal arteries involved are difficult to treat with medicines.Instead,surgery is often recommended for refractory renovascular hypertension with renal artery stenosis of ≥70%.Although both open surgery and endovascular surgery have been applied,the preferred surgical strategy remains undetermined. Read More

Neurol India 2020 Sep-Oct;68(5):1220-1223

Neurosurgeon and Interventional Neuroradiologist of Cajuru University Hospital of Pontifical Catholic University of Paraná (HUC-PUC PR), Curitiba - Parana, Brazil.

Background: Fibromuscular dysplasia affects generally renal artery, causing renovascular hypertension. The most classical angiographic pattern, string-of-beads, can be found in cervical and more rarely in other arteries. With the advance of endovascular procedures techniques, the number of open surgeries is decreasing, and complications related to the selective catheterization of diseased vessels are increasing. Read More

Sci Rep 2020 10 1;10(1):16300. Epub 2020 Oct 1.

Division of Nephrology and Hypertension, Mayo Clinic, 200 First St SW, Rochester, MN, 55905, USA.

Tissue fibrosis is an important index of renal disease progression. Diffusion-weighted magnetic resonance imaging's (DWI-MRI) apparent diffusion coefficient (ADC) reveals water diffusion is unobstructed by microstructural alterations like fibrosis. We hypothesized that ADC may indicate renal injury and response to therapy in patients with renovascular disease (RVD). Read More

Intern Med 2021 Jan 22;60(2):287-292. Epub 2020 Aug 22.

Division of Nephrology, Endocrinology, and Vascular Medicine, Tohoku University Graduate School of Medicine, Japan.

Angioplasty for cases of chronic total occlusion of renal artery with/without atrophic kidney is generally not recommended. We herein report a 57-year-old man who presented with renin-mediated refractory hypertension caused by occlusion of a unilateral renal artery leading to kidney atrophy (length: 69 mm). Angioplasty favorably achieved blood pressure control with normalized renin secretion and enlargement of the atrophic kidney to 85 mm. Read More

Integr Blood Press Control 2020 2;13:71-82. Epub 2020 Jun 2.

Ochsner Clinic Foundation, Department of Cardiovascular Medicine, New Orleans, LA, USA.

Atherosclerosis is the primary cause of renal artery stenosis. Atherosclerotic renal artery stenosis (ARAS) is associated with three clinical problems: renovascular hypertension, ischemic nephropathy and cardiac destabilization syndrome which pose huge healthcare implications. There is a significant rate of natural disease progression with worsening severity of renal artery stenosis when renal revascularization is not pursued in a timely manner. Read More

Ann Vasc Surg 2020 Nov 10;69:450.e1-450.e5. Epub 2020 Jun 10.

Department of Surgery, Section of Vascular Surgery and Endovascular Therapy, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico. Electronic address:

The middle aortic syndrome (MAS) is an uncommon clinical expression as a result of isolated stenosis or complete occlusion of the descending thoracic and/or abdominal aorta; Takayasu's arteritis (TA) is a rare vasculitis and a recognized etiology of MAS. We herein present the case of a 52-year-old woman with refractory renovascular hypertension and progressive bilateral lower extremity claudication; she had known history of TA. A computed tomography angiography demonstrated an aortic occlusive lesion compromising the origin of the celiac trunk, superior mesenteric, and bilateral renal arteries. Read More

Hypertension 2020 08 8;76(2):497-505. Epub 2020 Jun 8.

Cardiovascular Medicine (A.L.), Mayo Clinic, Rochester, MN.

The significance of peristenotic collateral circulation (PCC) development around a stenotic renal artery is unknown. We tested the hypothesis that PCC is linked to loss of kidney function and recovery potential in patients with atherosclerotic renovascular disease (ARVD). Thirty-four patients with ARVD were assigned to medical-therapy with or without revascularization based on clinical indications. Read More

Arthritis Rheumatol 2020 09 13;72(9):1570. Epub 2020 Jul 13.

Dr. von Hauner Children's Hospital Hospital of the Ludwig-Maximilians-University, Munich, Germany.

Cureus 2020 Apr 9;12(4):e7609. Epub 2020 Apr 9.

Radiology, James H. Quillen Veterans Affairs Medical Center, Johnson City, USA.

Renal hypoperfusion from renal artery stenosis (RAS) activates the renin-angiotensin system, which in turn causes volume overload and hypertension. Atherosclerosis and fibromuscular dysplasia are the most common causes of renal artery stenosis. Recurrent flash pulmonary edema, also known as Pickering syndrome, is commonly associated with bilateral renal artery stenosis. Read More

Can J Cardiol 2020 06 4;36(6):967.e9-967.e11. Epub 2020 Feb 4.

Division of Nephrology, Department of Medicine, The Ottawa Hospital, University of Ottawa, Ottawa, Ontario, Canada. Electronic address:

Revascularization of atherosclerotic renal artery stenosis may cure hypertension, but paradoxically, improvement in systemic blood pressure in response to successful revascularization may precipitate ischemia in other organs affected by previously silent atherosclerotic disease. We describe bowel ischemia secondary to preexisting celiac artery stenosis after revascularisation. Prior knowledge of multivessel disease facilitated prompt diagnosis and management of this condition. Read More

J Vasc Surg 2021 01 8;73(1):161-171. Epub 2020 Apr 8.

Section of Vascular Surgery, Department of Surgery, University of Michigan, Ann Arbor, Mich.

Objective: The pathologic nature of pediatric renal artery occlusive lesions causing renovascular hypertension has been the subject of numerous anecdotal reports. This study was undertaken to define the character of childhood renal artery stenoses. A better understanding of this disease is particularly germane, given its unknown etiology and the limited success of certain contemporary treatment options. Read More

J Vasc Surg 2020 12 8;72(6):2035-2046.e1. Epub 2020 Apr 8.

Section of Vascular Surgery, Department of Surgery, University of Michigan, Ann Arbor, Mich.

Background: Renovascular hypertension (RVH) associated with renal artery and abdominal aortic narrowings is the third most common cause of pediatric hypertension. Untreated children may experience major cardiopulmonary complications, stroke, renal failure, and death. The impetus of this study was to describe the increasingly complex surgical practice for such patients with an emphasis on anatomic phenotype and contemporary outcomes after surgical management as a means of identifying those factors responsible for persistent or recurrent hypertension necessitating reoperation. Read More

J Stroke Cerebrovasc Dis 2020 Aug 28;29(8):104786. Epub 2020 Mar 28.

Department of Neurosurgery, Tokyo Medical and Dental University, Tokyo, Japan.

Background: The de novo occurrence of renal artery stenosis in renal arteries that were angiographically confirmed to be normal in the past has never been reported before in patients with moyamoya disease.

Case Description: During the long-term follow-up of pediatric patients with moyamoya disease, we observed 3 patients who developed de novo renal artery stenosis in arteries that had been angiographically confirmed to be normal 1 year after the surgery (7 years on average, ranging from 4 to 11 years). All of these patients were neurologically stable after successful indirect bypass surgery during childhood. Read More

Indian Pediatr 2020 05 12;57(5):443-451. Epub 2020 Mar 12.

Division of Nephrology, Department of Pediatrics, Children's Hospital of Philadelphia, Philadelphia, PA, USA.

Renovascular hypertension (RVHTN) is an important contributor to secondary etiologies of hypertension in the pediatric population. A delay in diagnosis can be associated with adverse outcomes. The etiologies of renal artery stenosis (RAS) vary from anatomical, inflammatory, genetic syndromes, intra-luminal, external compression and idiopathic. Read More

J Clin Hypertens (Greenwich) 2020 04 16;22(4):678-682. Epub 2020 Mar 16.

Division of Nephrology, Department of Medicine, University of Ottawa, Ottawa, ON, Canada.

Drug-induced hypertension is one of the commonest causes of secondary hypertension. In the last few years, secondary hypertension due to tyrosine kinase inhibitors, from the vascular endothelial growth factor class, has been recognized to be an important cause of hypertension, as well as proteinuria, and occasionally kidney dysfunction in some cases. Less well-recognized is that BCR-ABL tyrosine kinase inhibitors also have adverse vascular effects. Read More

Am J Hypertens 2020 05;33(6):570-580

Division of Hypertension and Nephrology, National Cerebral and Cardiovascular Center, Osaka, Japan.

Background: We investigated the effects of percutaneous transluminal renal angioplasty on left ventricular (LV) mass, and the impact of LV mass reduction on outcomes.

Methods: A total of 144 hypertensive patients with renal artery stenosis (RAS) (mean age 69 years; 22.2% fibromuscular dysplasia (FMD)) who underwent angioplasty were included. Read More

Pediatr Int 2020 Aug 23;62(8):937-943. Epub 2020 Jul 23.

Division of Nephrology and Rheumatology, National Center for Child Health and Development, Tokyo, Japan.

Background: Despite advances in non-invasive vascular imaging, detection of renal artery stenosis via catheter angiography is the criterion standard for the diagnosis of renovascular hypertension (RVH). However, because of lack of evidence, the utility of various blood tests and imaging modalities remains unclear.

Methods: We retrospectively analyzed the utility of blood tests (plasma renin activity [PRA], aldosterone, and renal vein renin [RVR] values) and imaging studies (computed tomography angiography [CTA], kidney ultrasonography [US]) by comparing them with catheter angiography. Read More

Hypertension 2020 04 9;75(4):1102-1109. Epub 2020 Mar 9.

2nd Department of Radiology (O.R., M.J.), Medical University of Warsaw, Poland.

Fibromuscular dysplasia (FMD), regarded as a generalized vascular disease, may affect all vascular beds and may result in arterial stenosis, occlusion, aneurysm, or dissection. It has been proposed to systematically evaluate all vascular beds in patients with FMD, regardless of initial FMD involvement. However, the impact of this approach on clinical decisions and on management is unknown. Read More

Interv Cardiol Clin 2020 04 31;9(2):169-185. Epub 2020 Jan 31.

Department of Cardiovascular Diseases, John Ochsner Heart and Vascular Center, Ochsner Medical Center, The Ochsner Clinical School, University of Queensland, 1514 Jefferson Highway, New Orleans, LA 70121, USA; Department of Cardiology, Ochsner Medical Center, 3rd Floor, 1514 Jefferson Highway, New Orleans, LA 70121, USA. Electronic address:

Atherosclerotic renal artery stenosis is the most common cause of secondary hypertension and may cause progressive renal disease and cardiac destabilization syndromes. Guideline-directed medical therapy is advised in all patients. Patients with refractory symptoms and hemodynamically significant stenoses are more likely to benefit from renal artery stent placement. Read More

Am J Case Rep 2020 Feb 25;21:e921565. Epub 2020 Feb 25.

Nephrology Division, Federal University of São Paulo, São Paulo, SP, Brazil.

BACKGROUND Cocaine abuse is a globally recognized problem with great socioeconomic and health impacts on society. We report a case of dissection of vertebral arteries and right renal artery after cocaine abuse that clinically presented as atypical headache and hypertension. CASE REPORT A 36-year-old male sought emergency care due to cervical pain after cocaine abuse. Read More

Am J Hypertens 2020 04;33(5):391-401

Department of Medicine, Katta General Hospital, Shiroishi, Japan.

Atherosclerotic renal artery stenosis (ARAS) can cause secondary hypertension, progressive decline in renal function, and cardiac complications. Recent randomized controlled trials including the Cardiovascular Outcomes in Renal Atherosclerotic Lesions study have not reported the benefit of renal artery stenting compared with medical therapy alone to improve renal function or reduce cardiovascular and renal events in the enrolled patients with ARAS. However, observational evidence indicating the benefits of angioplasty in the selected high-risk patients with ARAS has been increasing. Read More

Turk J Pediatr 2019 ;61(4):629-634

Departments of Medical Imaging, Changhua Christian Children's Hospital, Changhua.

Lee ML, Chang TM, Yang RC, Yang AD, Chen M. Systemic hypertension followed by insidious stroke in a 12-year-old boy with childhood neurofibromatosis type 1 presenting with renal and cerebral artery vasculopathy. Turk J Pediatr 2019; 61: 629-634. Read More

Catheter Cardiovasc Interv 2020 02 13;95 Suppl 1:641-647. Epub 2020 Jan 13.

Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.

Objectives: This study aimed to evaluate the safety and efficiency of percutaneous transluminal angioplasty (PTA) with selective stenting treating Chinese patients with renal artery stenosis (RAS) due to fibromuscular dysplasia (FMD).

Background: Endovascular data of patients with RAS caused by FMD are scarce in China.

Methods: Clinical data of 105 hypertensive patients with RAS caused by FMD underwent endovascular therapy at a single-site between June 2001 and October 2018 were analyzed retrospectively. Read More