Related Experiment Video
Updated: Aug 29, 2025
08:21
A Modified Two Kidney One Clip Mouse Model of Renin Regulation in Renal Artery Stenosis
Published on: October 26, 2020
5.0K
Renal Artery Stenosis due to Entrapment
Dongjin Suh1, Victor H Hatcher1, John Muhonen1
1Department of Surgery, University of Iowa Hospitals and Clinics, Iowa City, IA.
Annals of Vascular Surgery
|September 4, 2022
Summary
Extrinsic renal artery compression, though rare, can cause renovascular hypertension. Surgical decompression offers a curative solution, improving blood pressure and resolving infarcts in affected patients.
Area of Science:
- Vascular Surgery
- Nephrology
- Radiology
Background:
- Renovascular occlusive disease commonly stems from atherosclerosis, fibromuscular dysplasia, or vasculitis.
- Extrinsic compression of the renal artery is an uncommon cause of renovascular hypertension, presenting with similar symptoms.
Purpose of the Study:
- To describe the diagnosis and surgical management of extrinsic renal artery compression due to entrapment.
- To highlight the importance of considering extrinsic compression in renovascular hypertension workup.
Main Methods:
- Diagnosis involved computed tomography angiography, dynamic duplex sonography, and catheter angiography in two patients.
- Both patients underwent open surgical decompression via an extended Kocher maneuver for right-sided renal artery entrapment.
Main Results:
- Surgical decompression was uncomplicated, with intraoperative sonography confirming restored luminal patency.
- Follow-up demonstrated resolution of dynamic compression, normalized renal artery velocities, improved blood pressure control, and cessation of anticoagulation in one patient.
Conclusions:
- Extrinsic renal artery compression by diaphragmatic crura is rare but should be suspected in patients without typical vascular risk factors.
- Dynamic imaging during expiration is crucial for diagnosis, and surgical or laparoscopic decompression can be curative.
Related Concept Videos
01:26Aneurysm III: Interprofessional Care
17
Aneurysm management involves either conservative medical therapy or surgical intervention, depending on the size and symptoms of the aneurysm. Conservative management is generally reserved for smaller, asymptomatic aneurysms, while larger or symptomatic aneurysms often necessitate surgical repair.Conservative Medical TherapyFor small, asymptomatic aneurysms, particularly abdominal aortic aneurysms (AAA) less than 5.5 centimeters in diameter, conservative medical therapy is recommended. This...
17
01:29Acute Kidney Injury II: Pathophysiology
59
Acute kidney injury (AKI) causes are categorized into three primary categories based on the location of the injury: prerenal, intrarenal (or intrinsic), and postrenal causes. This classification guides clinical management and illustrates how different pathways can impair kidney function.Etiology and Pathophysiology of Acute Kidney Injury1. Prerenal causesEtiology: Prerenal Acute Kidney Injury, the most common type, occurs when reduced blood flow to the kidneys decreases filtration capacity...
59
01:21Aneurysm II: Clinical Manifestations and Diagnostic Studies
19
Thoracic, aortic arch and abdominal aneurysms are significant vascular conditions that can present with various clinical manifestations and lead to serious complications. Understanding these manifestations and the appropriate diagnostic studies is essential for effective management and treatment.Thoracic Aortic AneurysmsThoracic aortic aneurysms often remain asymptomatic until they reach a size that impinges on adjacent structures. They typically cause deep, diffuse chest pain that radiates to...
19
01:19Imaging Studies VII: Vascular Imaging
50
DefinitionRenal angiography, also known as renal arteriography, is an imaging technique used to obtain a comprehensive view of blood flow and the vascular structure of blood vessels in the kidneys and surrounding areas.PurposeRenal angiography detects blood vessel abnormalities in the kidneys, such as aneurysms, stenosis, thrombosis, vascular tumors, and renal artery stenosis. It evaluates kidney function and guides interventional treatments like angioplasty or stent placement.Pre-Procedure...
50
01:15Aortic Regurgitation I: Introduction
29
IntroductionAortic regurgitation is characterized by the backward flow of blood from the aorta into the left ventricle during diastole and arises from the improper closure of the aortic valve. This condition results in left ventricular volume overload and can stem from both acute and chronic etiologies, each contributing uniquely to the disease's progression and symptomatology.Acute and Chronic CausesAcute aortic regurgitation often results from events that suddenly impair the integrity of the...
29
01:30Peripheral Artery Disease I: Introduction
27
Peripheral artery disease (PAD) predominantly results from atherosclerosis, which involves the accumulation of fatty deposits, or plaques, within the walls of arteries. This causes them to narrow and harden, significantly reducing blood flow. PAD predominantly affects the legs, particularly the arteries supplying the thighs and calves. In rare cases, it may involve other arteries, including those in the arms.Etiology of PAD:The principal cause of PAD is atherosclerosis, which results from fatty...
27