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Published on: July 7, 2013
Bilateral renal artery aneurysm: percutaneous treatment with stent-graft placement
R Gandini1, A Spinelli, E Pampana
1Department of Diagnostic Imaging and Interventional Radiology, University of Tor Vergata, Viale Oxford 81, 00133 Rome, Italy.
Insights
This study demonstrates successful treatment of bilateral renal artery stenosis and aneurysms using stent-grafts. The procedure significantly improved blood pressure and renal function in a patient with renovascular hypertension.
Area of Science:
- Interventional Cardiology
- Nephrology
- Vascular Surgery
Background:
- Renovascular hypertension poses a significant risk for cardiovascular and renal complications.
- Bilateral renal artery stenosis and aneurysms present complex therapeutic challenges.
- Accurate diagnosis is crucial for effective management of renal artery disease.
Observation:
- A 51-year-old male presented with severe hypertension and impaired renal function.
- Doppler ultrasound and magnetic resonance angiography identified bilateral renal artery stenosis and aneurysms.
- The patient had a history of poorly controlled hypertension despite dual-drug therapy.
Findings:
- Successful deployment of bilateral polytetrafluoroethylene (PTFE)-covered nitinol stent-grafts.
- Post-procedure angiography confirmed resolution of stenosis and aneurysm exclusion.
- Six-month follow-up showed restored renal artery patency, reduced blood pressure, and improved renal function.
Implications:
- Stent-graft repair is an effective treatment for complex bilateral renal artery stenosis and aneurysms.
- This intervention can lead to significant clinical improvement in patients with renovascular hypertension.
- Minimally invasive techniques offer a promising approach to managing challenging vascular conditions.
Abstract:
A 51-year-old man with an 8-year history of hypertension (170/115 mmHg with two drugs) and altered renal function (5.6 mg/dl serum creatinine, 101 mg/dl BUN) was referred to our Department to evaluate the renal arteries and rule out renovascular hypertension. Doppler ultrasound and magnetic resonance angiography revealed significant bilateral renal artery stenosis and the presence of bilateral renal artery aneurysms. A self-expandable polytetrafluoroethylene (PTFE)-covered nitinol stent-graft was deployed in each renal artery to treat the stenoses and to exclude the aneurysm. Postprocedural digital subtraction angiography confirmed the resolution of the renal artery stenoses and the complete exclusion of the aneurysms. At the 6 month follow-up, color Doppler confirmed normal patency of the renal arteries with complete exclusion of the aneurysms and significant reduction of the blood pressure (130/85 mmHg with one drug) and serum creatinine levels (2.1 mg/dl).
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