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Kidney Int 2019 Apr;95(4):948-957

Division of Nephrology and Hypertension, Mayo Clinic, Rochester, Minnesota, USA. Electronic address:

The relationships between renal blood flow (RBF), tissue oxygenation, and inflammatory injury in atherosclerotic renovascular disease (ARVD) are poorly understood. We sought to correlate RBF and tissue hypoxia with glomerular filtration rate (GFR) in 48 kidneys from patients with ARVD stratified by single kidney iothalamate GFR (sGFR). Oxygenation was assessed by blood oxygenation level dependent magnetic resonance imaging (BOLD MRI), which provides an index for the levels of deoxyhemoglobin within a defined volume of tissue (R2*). Read More

J Ultrason 2018 ;18(75):338-343

Department of General Surgery and Endocrinology, Medical University of Warsaw , Poland.

The present clinical practice recommendations are addressed to physicians of all specialties, who perform Doppler ultrasound examinations of the kidneys on a daily basis, and in particular to specialists in radiology and imaging diagnostics. The recommendations were based on the Ultrasonography Standards of the Polish Ultrasound Society and current scientific reports consistent with Evidence Based Medicine. The paper discusses patient preparation protocol, examinat ion technique with particular emphasis on patient's position allowing to obtain proper Doppler angle of insonation, as well as diagnostic limitations of the technique. Read More

Rev Assoc Med Bras (1992) 2018 Aug;64(8):723-728

. Pediatric Nephrology Unit, Institute of Children, Hospital das Clínicas, Faculty of Medicine, University of São Paulo, São Paulo, Brasil.

Aim: To describe the incidence, diagnosis, and management of systemic arterial hypertension related to renal artery stenosis in patients with Williams-Beuren syndrome.

Methods: Sixty-five patients with Williams-Beuren syndrome were evaluated for hypertension. Enrolled patients underwent Doppler sonography of the renal arteries and Doppler echocardiography. Read More

Cureus 2018 Nov 12;10(11):e3573. Epub 2018 Nov 12.

Neurology, University of Missouri, Columbia, USA.

Posterior reversible encephalopathy syndrome (PRES) is a clinico-radiologic syndrome resulting in subcortical vasogenic edema appreciated on T2/fluid-attenuated inversion recovery (FLAIR) sequence of magnetic resonance imaging (MRI). PRES classically involves bilateral parieto-occipital lobes and is usually reversible. Atypical variant of PRES includes the involvement of brainstem, basal ganglia, thalami, or periventricular white matter. Read More

Chin Med J (Engl) 2019 Jan;132(1):63-68

Department of Sonography, Beijing Hospital, National Center of Gerontology, Beijing 100730, China.

Background: Renal artery stenosis (RAS) is always associated with abnormalities in renal microvascular perfusion (RMP). However, few imaging methods can simultaneously evaluate the degree of luminal stenosis and RMP. Thus, this study will aim to evaluate the feasibility of using contrast-enhanced ultrasound (CEUS) for assessing both RAS and RMP to achieve a one-stop assessment of patients with suspected renovascular hypertension. Read More

Eurasian J Med 2018 Oct;50(3):210-212

Department of Cardiology, Istanbul Medeniyet University School of Medicine, İstanbul, Turkey.

A 23-year-old female patient with factor VII (FVII) deficiency was admitted with severe hypertension and renal failure. Brachial arterial pressures were 230/120 and 220/115 mm/Hg on the right and left arms, respectively. There was no blood pressure difference between the arms. Read More

Int J Rheum Dis 2019 Jan 5;22(1):140-151. Epub 2018 Nov 5.

Allergy Immunology Unit, Department of Paediatrics, Advanced Paediatrics Centre, Postgraduate Institute of Medical Education and Research, Chandigarh, India.

Aim: To report our experience on complex percutaneous interventions of the abdominal aorta and its branches in six children with Takayasu arteritis (TA).

Methods: A review of records of children with TA, who underwent percutaneous interventions of the abdominal aorta and its major branches.

Results: In this analysis, we included six children with TA who underwent intervention of the abdominal aorta and its major branches. Read More

Am J Med Genet A 2018 Nov 5;176(11):2523-2527. Epub 2018 Oct 5.

Department of Paediatrics and Adolescent Medicine, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong.

J Vasc Interv Radiol 2018 11 28;29(11):1613-1616. Epub 2018 Sep 28.

7810 Lookout Drive, La Jolla, California. Electronic address:

Sci Rep 2018 Jun 5;8(1):8598. Epub 2018 Jun 5.

Department of Laboratory Medicine & Pathology, Mayo Clinic, Rochester, MN, USA.

Inflammation plays an important role in the pathogenesis of renal and cardiovascular disease in renovascular hypertension (RVH). Ccl2 is an important mediator of inflammation, and is induced within 24 hours following surgery to establish RVH in the murine 2 kidney 1 clip model, a time prior to onset of interstitial inflammation, fibrosis, or tubular atrophy. We tested the hypothesis that Ccl2 deficiency protects the stenotic kidney (STK) from development of chronic renal damage in mice with renovascular hypertension due to renal artery stenosis (RAS). Read More

Pediatr Nephrol 2018 Sep 4;33(9):1593-1599. Epub 2018 Jun 4.

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

Background: Fibromuscular dysplasia (FMD) is a non-inflammatory vascular disease that in children unlike in adults shows no sex predilection. FMD is often underdiagnosed, and its pathophysiology is unclear. Delayed diagnosis may lead to refractory hypertension and decreases the chance of successful treatment. Read More

Kardiol Pol 2018 ;76(5):929

Instytut Kardiologii.

Intern Med 2018 Sep 27;57(18):2689-2694. Epub 2018 Apr 27.

Endocrinology & Diabetes Center, Yokohama Rosai Hospital, Japan.

A 33-year-old man was admitted to our hospital to undergo an evaluation to determine the cause of secondary hypertension. Computerized tomography angiography (CTA) showed bilateral multiple renal arteries with significant stenosis of the right extra-renal artery due to fibromuscular dysplasia and segmental impairment of renal perfusion. Although the plasma aldosterone concentration and plasma renin activity were within the normal ranges, percutaneous balloon dilatation of the stenotic lesion resolved his hypertension, leading to a diagnosis of renovascular hypertension caused by segmental renal ischemia due to extra-renal artery stenosis. Read More

Clin Exp Nephrol 2018 Dec 20;22(6):1294-1299. Epub 2018 Apr 20.

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

Background: Fibromuscular dysplasia (FMD), which usually affects the renal artery, also affects the carotid, vertebral, and intracranial arteries. Previous studies have shown a high prevalence of concomitant renal artery and cervicocranial lesions in FMD patients. However, the analyzed subjects were mostly Caucasians in Western countries. Read More

Indian J Med Res 2017 Nov;146(Supplement):S22-S29

Department of Neuroradiology, Sri Ramachandra Medical College & Research Institute, Sri Ramachandra University, Chennai, India.

Background & Objectives: Renal artery stenosis (RAS) is an important cause of severe hypertension in patients with chronic kidney disease (CKD). It is important to detect RAS early as it can reverse hypertension and stop rapid deterioration of renal function. The potential drawbacks of various imaging modalities used to detect RAS including contrast-related adverse effects associated with diagnostic angiography have led to increasing interest in unenhanced magnetic resonance (MR) renal angiography. Read More

BMC Nephrol 2018 03 9;19(1):56. Epub 2018 Mar 9.

Department of Intervention, First Affiliated Hospital, China Medical University, No.155, Nanjing North Street, Shenyang, Liaoning Province, 110001, People's Republic of China.

Background: Renal transplant is the preferred treatment option for these patients with end-stage renal disease. Transplant renal artery stenosis (TRAS) is one of the most common and serious vascular complications after renal transplantation, and most of the TRAS occurred in the anastomosis. The complication must be diagnosed and treated timely, otherwise the function of transplanted kidney may be losed. Read More

J Korean Med Sci 2018 Mar 5;33(10):e76. Epub 2018 Mar 5.

Department of Medical Imaging, Changhua Christian Hospital, Changhua, Taiwan.

Concurrent involvement of bilateral renal and cerebral arteries, usually incurred as stenosis, is rare in childhood-onset Takayasu arteritis (c-TA). We report the case of a 14-year-old girl, with c-TA, presenting with transient ischemic attack after endovascular revascularization for renal artery stenosis and cerebrovascular stroke after surgical revascularization for cerebral artery stenosis associated with childhood-onset moyamoya syndrome. We deem that decrease of blood pressure by endovascular revascularization and improvement of cerebral perfusion by surgical revascularization may have jeopardized the cerebral deep watershed zone to cerebral ischemia followed by cerebral hyperperfusion syndrome and caused transient ischemic attack and cerebrovascular stroke in our patient. Read More

Am J Kidney Dis 2018 May 9;71(5):748-753. Epub 2018 Feb 9.

Division of Nephrology and Hypertension, Mayo Clinic, Rochester MN. Electronic address:

Current trends in managing atherosclerotic renal artery stenosis favor medical therapy, on account of negative results from prospective trials of revascularization, such as CORAL and ASTRAL. One result of this trend has been encountering occasional patients with progressive disease, sometimes leading to total arterial occlusion. We illustrate a case of accelerated hypertension with complete renal artery occlusion in which the patient recovered function after surgical bypass and we review the clinical approach used and the advanced imaging modalities available to us. Read More

J Pediatr Surg 2018 Sep 24;53(9):1825-1831. Epub 2017 Dec 24.

Division of Pediatric General and Thoracic Surgery, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA. Electronic address:

Introduction: Renal artery occlusive disease is poorly characterized in children; treatments include medications, endovascular techniques, and surgery. We aimed to describe the course of renovascular hypertension (RVH), its treatments and outcomes.

Methods: We performed literature review and retrospective review (1993-2014) of children with renovascular hypertension at our institution. Read More

Medicine (Baltimore) 2017 Dec;96(50):e8896

State Key Laboratory of Cardiovascular Disease, National Center for Cardiovascular Diseases, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.

Rationale: Iliac arterial fibromuscular dysplasia (FMD) was rarely reported and its demographic, clinical, and imaging features have not been precisely described resulting in uncertain therapeutic methods.

Patient Concerns: A 31-year-old man was referred because of 3-month-ago onset hypertension, low serum potassium, and a small-sized right kidney with normal renal artery under ultrasound examination. This patient was suspected of primary aldosteronism, whereas spirolactone was poorly effective. Read More

Kidney Int 2018 02;93(2):526

Pediatric Nephrology Department, Robert Debré Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France. Electronic address:

Gastroenterology 2018 Feb 18;154(3):e10-e11. Epub 2018 Jan 18.

Department of Internal Medicine, Division of Hospital Medicine, University of South Florida Morsani College of Medicine, Tampa, Florida.

J Am Coll Radiol 2017 Nov;14(11S):S540-S549

Panel Chair (Urologic), University of Alabama at Birmingham, Birmingham, Alabama.

Renovascular hypertension is the most common type of secondary hypertension and is estimated to have a prevalence between 0.5% and 5% of the general hypertensive population, and an even higher prevalence among patients with severe hypertension and end-stage renal disease, approaching 25% in elderly dialysis patients. Investigation for renal artery stenosis is appropriate when clinical presentation suggests secondary hypertension rather than primary hypertension, when there is not another known cause of secondary hypertension, and when intervention would be carried out if a significant renal artery stenosis were identified. Read More

Catheter Cardiovasc Interv 2018 03 25;91(4):760-764. Epub 2017 Oct 25.

Sulpizio Cardiovascular Center, University of California, San Diego, La Jolla, California.

Renal artery stenosis (RAS) is a prevalent cause of secondary hypertension. Elderly patients with atherosclerosis and young women with fibromuscular dysplasia (FMD) are particularly at risk. Blood pressure screening is often key to this diagnosis, although the reliability of clinical screening has been questioned, and ambulatory blood pressure monitoring (ABPM) likely offers superior ability to diagnose poorly controlled hypertension. Read More

Am J Hypertens 2018 Jan;31(2):139-149

Division of Nephrology and Hypertension, Mayo Clinic, Rochester, Minnesota, USA.

Renovascular disease (RVD) remains a major cause of secondary and treatment-resistant hypertension. Most cases are related either to fibromuscular or atherosclerotic lesions, but a variety of other causes including arterial dissection, stent occlusion, and embolic disease can produce the same syndrome. Recent studies emphasize the kidney's tolerance to moderate flow reduction during antihypertensive drug therapy and the relative safety of medical therapy to control blood pressure. Read More

Circ Cardiovasc Interv 2017 Sep;10(9)

From the Division of Nephrology and Hypertension (A.S., S.M.S.H., A.E., C.M.F., L.O.L., S.C.T.) and Department of Radiology (J.F.G., H.B., M.A.M., S.M.), Mayo Clinic, Rochester, MN.

Background: Atherosclerotic renal artery stenosis reduces renal blood flow (RBF) and amplifies stenotic kidney hypoxia. Revascularization with percutaneous transluminal renal angioplasty (PTRA) and stenting often fails to recover renal function, possibly because of ischemia/reperfusion injury developing after PTRA. Elamipretide is a mitochondrial-targeted peptide that binds to cardiolipin and stabilizes mitochondrial function. Read More

BMJ Case Rep 2017 Aug 16;2017. Epub 2017 Aug 16.

Department of Nephrology, South West Thames Renal & Transplantation Unit, St Helier Hospital, Carshalton, UK.

Renal Artery Stenosis (RAS) is an important cause of treatment-resistant hypertension. Uncontrolled hypertension with RAS can cause progressive chronic kidney disease (CKD) leading to end-stage kidney disease. Therapeutic revascularisation can be helpful in appropriate circumstances where pharmaceutical intervention has failed and significant renovascular disease contributes to resistant hypertension. Read More

Trials 2017 08 14;18(1):380. Epub 2017 Aug 14.

Center for Internal Medicine/Nephrology, Klinikum I, Johannes Wesling Klinikum Minden, Minden, Germany.

Background: The indications for conservative "best medical treatment" (BMT) versus additional renal artery stenting are a matter of ongoing debate. The RADAR study aimed to evaluate the impact of percutaneous renal artery stenting on the impaired renal function in patients with hemodynamically significant atherosclerotic renal artery stenosis (RAS).

Methods: RADAR is an international, prospective, randomized (1:1) controlled study comparing BMT alone versus BMT plus renal artery stenting in patients with duplex sonographic hemodynamically relevant RAS. Read More

Clinics (Sao Paulo) 2017 Jul;72(7):411-414

Unidade de Hipertensão, Divisão de Cardiologia, Instituto do Coração (InCor), Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, BR.

Objective:: The purpose of this study was to evaluate the association between the presence of clinical symptoms of peripheral artery disease and severe renal artery stenosis in patients referred for renal angiography.

Method:: We included 82 patients with clinical suspicion of renovascular hypertension and performed an imaging investigation (renal Doppler ultrasound and/or renal scintigraphy) for possible renal artery stenosis. All patients underwent renal arteriography and were examined for peripheral artery disease based on the presence of intermittent claudication and ankle-brachial index test results. Read More

Pediatr Radiol 2017 Aug 4;47(9):1116-1124. Epub 2017 Aug 4.

Department of Radiology, Division of Thoracoabdominal Imaging, Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, 3333 Burnet Ave., Cincinnati, OH, 45229-3039, USA.

The incidence of primary (i.e. essential) hypertension in children and adolescents is increasing; however, secondary hypertension, with an identifiable cause, remains relatively common and might be treatable or even curable. Read More

Clin Exp Hypertens 2017 16;39(7):587-591. Epub 2017 Jun 16.

a Department of Cardiology , West China Hospital, Sichuan University , Chengdu , China.

We report a 14-year-old boy with recurrent episodes of headache caused by uncontrolled hypertension. The diagnosis of renovascular hypertension due to Takaysu arteritis (TA) was made based on an increase in erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) and computed tomography (CT) image of bilateral renal artery stenosis was taken. Renal scintigraphy revealed normal perfusion and function of the right kidney and severe reduction of the perfusion and function of the left kidney. Read More

Angiol Sosud Khir 2017;23(2):159-163

Clinic for vascular and endovascular surgery, Clinic Center of Serbia; Faculty of Medicine, University of Belgrade, Serbia.

In this paper, we present a case of kidney injury as a complication of renal artery angioplasty in a 54-year-old female patient that suffered from resistant renovascular hypertension. This case emphasises the unpredictable nature of endovascular procedures, the need for careful post-procedure evaluation and the role of 'old fashioned' surgical techniques in resolving complications of endovascular procedures. Read More

Exp Ther Med 2017 Jun 26;13(6):3291-3296. Epub 2017 Apr 26.

Department of Vascular Surgery, Xuan Wu Hospital and Institute of Vascular Surgery, Capital Medical University, Beijing 100053, P.R. China.

The aim of the present study was to establish and evaluate a novel and reversible two-kidney, one-clip renovascular hypertensive rat model with a titanium vascular clip. A total of 40 male Sprague-Dawley rats were evenly and randomly divided into a sham-operated group, and 3, 7, 12 and 28D groups (namely removing the vascular clip in the renovascular hypertensive model after 3, 7, 12 and 28 days, respectively). The systolic blood pressure (SBP) and plasma renin activity (PRA) were measured, and color duplex imaging was conducted before placing the clips, as well as before and after removing them. Read More

J Clin Hypertens (Greenwich) 2017 Oct 30;19(10):1028-1031. Epub 2017 May 30.

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

We report the case of a young woman treated with selective renal embolization for renovascular hypertension caused by intrarenal artery stenosis and show follow-up imaging of the treated kidney. An 18-year-old woman had renin-dependent hypertension with intrarenal artery stenosis caused by fibromuscular dysplasia. A middle branch artery was nearly occluded, resulting in segmental renal ischemia with excessive renin secretion. Read More

Abdom Radiol (NY) 2017 10;42(10):2479-2487

Department of Radiology, Ruijin hospital, Shanghai Jiaotong University School of Medicine, No 197 Ruijin ER road, 200025, Shanghai, China.

Purpose: To assess the capability of inflow inversion recovery (IFIR) magnetic resonance angiography (MRA), compared with contrast-enhanced MRA (CE-MRA) as reference standard, in evaluating renal artery stenosis (RAS).

Methods: Seventy-two subjects were examined by IFIR MRA with respiratory-gated, prior to CE-MRA with a 1.5-T scanner. Read More

J Am Soc Nephrol 2017 Sep 1;28(9):2777-2785. Epub 2017 May 1.

Divisions of *Nephrology and Hypertension and

Atherosclerotic renovascular disease (RVD) reduces renal blood flow (RBF) and GFR and accelerates poststenotic kidney (STK) tissue injury. Preclinical studies indicate that mesenchymal stem cells (MSCs) can stimulate angiogenesis and modify immune function in experimental RVD. We assessed the safety and efficacy of adding intra-arterial autologous adipose-derived MSCs into STK to standardized medical treatment in human subjects without revascularization. Read More

Exp Clin Transplant 2017 Dec 22;15(6):615-619. Epub 2017 Mar 22.

Department of Kidney Transplantation, Second Hospital of Shandong University, Jinan 250000, China.

Objectives: Transplant renal artery stenosis is a frequently recognized complication of kidney transplant procedures. A single-center retrospective study was conducted to examine the use of 3-dimensional computed tomography reconstruction in diagnosing transplant artery stenosis.

Materials And Methods: During 2013 at our center, 86 patients underwent kidney transplant. Read More

Curr Probl Cardiol 2017 Apr 20;42(4):110-135. Epub 2017 Jan 20.

Atherosclerotic renal artery stenosis is the leading cause of secondary hypertension; it can also cause progressive renal insufficiency and cardiovascular complications such as refractory heart failure and flash pulmonary edema. Medical therapy including risk factor modification, renin-angiotensin-aldosterone system antagonists, lipid lowering agents, and antiplatelet therapy is the first line of treatment in all patients. Patients with uncontrolled renovascular hypertension despite optimal medical therapy, ischemic nephropathy, and cardiac destabilization syndromes who have severe renal artery stenosis are likely to benefit from renal artery revascularization. Read More

PLoS One 2017 17;12(3):e0173562. Epub 2017 Mar 17.

Department of Medicine, University of Toledo College of Medicine and Life Sciences, Toledo, OH, United States of America.

Cigarette smoking causes cardiovascular disease and is associated with poor kidney function in individuals with diabetes mellitus and primary kidney diseases. However, the association of smoking on patients with atherosclerotic renal artery stenosis has not been studied. The current study utilized data from the Cardiovascular Outcomes in Renal Atherosclerotic Lesions (CORAL, NCT00081731) clinical trial to evaluate the effects of smoking on the risk of cardio-renal events and kidney function in this population. Read More

Iran J Kidney Dis 2017 Mar;11(2):79-89

Department of Nephrology, Masih Daneshvari Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

Renovascular disease includes renal artery stenosis, renovascular hypertension, and azotemic renovascular disease (ischemic nephropathy). Renovascular hypertension is defined as an elevated blood pressure caused by renal hypoperfusion, usually resulting from anatomic stenosis of the renal artery and activation of the renin-angiotensin system. It accounts for 1% to 2 % of all cases of hypertension in the general population and 5. Read More

Tex Heart Inst J 2017 Feb 1;44(1):50-54. Epub 2017 Feb 1.

Renal artery stenosis caused by neurofibromatosis is a rare cause of renovascular hypertension. This hypertension can develop during childhood and is one of the leading causes of poor outcome. We report the case of a 17-year-old girl who was incidentally diagnosed with severe hypertension. Read More

Vasa 2017 Jul 20;46(4):313-318. Epub 2017 Feb 20.

1 Department of Cardiothoracic, Transplantation and Vascular Surgery, Hannover Medical School, Germany.

Fibromuscular dysplasia is a non-inflammatory, non-atherosclerotic vascular disease, occurring predominantly in younger females. A histologically heterogeneous group of fibroplasia without an inflammatory component causes arterial narrowing. It affects mostly one or both renal arteries, cervicocranial or visceral arteries, leading to hypertension, renal failure/renal infarction or stroke/transient ischaemic attack. Read More

Radiology 2017 07 17;284(1):200-209. Epub 2017 Feb 17.

From the Department of Radiology and Imaging Sciences (A.T.T., R.D.F., A.P., R.H.) and Department of Biostatistics and Bioinformatics (A.K.M.F.R., A.M.), Emory University School of Medicine, 1364 Clifton Rd, Atlanta, GA 30322; Veterans Administration Medical Center, Decatur, Ga (A.T.T.); and Departments of Biostatistics (A.K.M.F.R.) and Radiology (E.V.D.), University of Alabama, Birmingham, Ala.

Purpose To determine if commonly administered doses of technetium 99m (Tc) mertiatide (MAG) in the range of 300-370 MBq (approximately 8-10 mCi) contribute to image interpretation and justify the resulting radiation exposure. Materials and Methods The respective institutional review boards approved this HIPAA-compliant study and waived informed consent. Baseline and furosemide Tc-MAG imaging examinations in 50 patients suspected of having renal obstruction and 48 patients suspected of having renovascular hypertension (RVH) were randomly selected from archived databases and were independently scored by three experienced readers without access to 2-second flow images. Read More

Nephrology (Carlton) 2017 Mar;22(3):257-260

Diagnostic and Interventional Radiology and Nuclear Medicine.

Renovascular stenosis is an important cause for arterial hypertension in childhood. We report a 10-month-old girl with arterial hypertension caused by right-sided renal artery stenosis detected by Doppler ultrasound. Magnetic resonance imaging (MRI) was performed before renal artery angioplasty to depict vascular anatomy in detail and to retrieve additional functional information of the kidneys by analysis of intravoxel incoherent motion (IVIM). Read More

Vasc Endovascular Surg 2017 Jan 19;51(1):4-11. Epub 2016 Dec 19.

1 Department of Interventional Medicine, the Second Hospital of Shandong University, Jinan, China.

Purpose: To evaluate the outcomes of percutaneous intervention (PI) for transplant renal artery stenosis (TRAS).

Materials And Methods: Doppler ultrasonography was used as the screening tool, and angiography was the diagnostic method for TRAS. The indications for PI were (1) a reduction in lumen diameter of >50% or (2) a mean pressure gradient of >15 mm Hg. Read More

EuroIntervention 2017 Jun 2;13(2):e248-e255. Epub 2017 Jun 2.

Medizinische Klinik und Poliklinik, Klinikum Rechts der Isar, Technische Universität München, Munich, Germany.

Aims: The aim of this study was to assess the impact of drug-eluting stents (DES) compared to bare metal stents (BMS) for the endovascular treatment of atherosclerotic renal artery stenosis (ARAS).

Methods And Results: We retrospectively evaluated all of our endovascular BMS and DES implantations performed in de novo ARAS between 2000 and 2014 at our institution. The occurrence of in-stent restenosis (ISR) detected by ultrasound or angiography, kidney function, blood pressure (BP), and the number of antihypertensive drugs were analysed as endpoints. Read More

J Cardiovasc Surg (Torino) 2017 Apr 19;58(2):329-338. Epub 2016 Dec 19.

Department of Vascular Surgery, University Hospital of Saint-Etienne, Saint-Etienne, France.

The management of atherosclerotic renal artery stenosis (ARAS) in patients with hypertension has been the topic of great controversy. Major contemporary clinical trials such as the Cardiovascular Outcomes for Renal Artery lesions (CORAL) and Angioplasty and Stenting for Renal Atherosclerotic lesions (ASTRAL) have failed to show significant benefit of revascularization over medical management in controlling blood pressure and preserving renal function. We present here the implications and limitations of these trials and formulate recommendations for management of ARAS. Read More

Adv Exp Med Biol 2017 ;956:191-208

Experimental and Clinical Department, University of Florence, Florence, Italy.

Ultrasound (US) allows the non-invasive evaluation of morphological changes of kidney structure (by means of B-Mode) and patterns of renal and extrarenal vascularization (by means of color-Doppler and contrast-enhanced US). In hypertensive subjects it offers a relevant contribution to the diagnosis of early renal damage, acute or chronic nephropathies and nephrovascular disease. However, morphological changes are often detected late and non-specific and in recent years evidence has increased regarding the clinical relevance of renal resistive index (RRI) for the study of vascular and renal parenchymal renal abnormalities. Read More

Adv Exp Med Biol 2017 ;956:209-213

Lankenau Medical Center, 100 Lancaster Avenue, Suite 130, 19096, Wynnewood, PA, USA.

Atherosclerotic Renal Artery Stenosis is a form or peripheral arterial disease that tends to affect older subjects with hyperlipidemia, history of tobacco use, and who have other coexistent forms of vascular insufficiency. An abdominal bruit on physical exam can be a helpful clue. Slowly progressive, it can lead to critical narrowing of the renal arteries which creates a cascade of events such as renin-angiotensin-aldosterone activation (RAAS), hypertension, acute pulmonary edema, and renal fibrosis. Read More

Hypertension 2017 01 21;69(1):109-117. Epub 2016 Nov 21.

From the Division of Hypertension and Nephrology (Y.I., H.K., S.-i.H., M.K., F.Y., S.N., Y.K.), and Department of Radiology (T.F.), Department of Medicine, National Cerebral and Cardiovascular Center, Osaka, Japan; Division of Health Science, Osaka University Graduate School of Medicine, Japan (K.K.); Department of Internal Medicine, Kawasaki Hospital, Kawasaki Medical School, Okayama, Japan (T.H.); and Department of Medical Technology, Teikyo University Fukuoka, Japan (Y.K.).

This study included 126 hypertensive patients with renal artery stenosis (mean age, 63 years; 22.2% fibromuscular dysplasia [FMD]) and investigated the effects of percutaneous transluminal renal angioplasty on office and home blood pressure (BP), and BP variability estimates derived from home BP, both at baseline and up to 12 months after angioplasty. Home BP was measured for 7 consecutive days, and the threshold defining uncontrolled home BP was ≥135/85 mm Hg. Read More