Successful endovascular treatment of chronic renal artery occlusion: a preliminary retrospective case series including 15 patients

Yang, Min; Lin, Letao; Niu, Guochen; Zhang, Yan; Zhang, Bihui; Tong, Xiaoqiang; Zou, Yinghua

doi:10.1007/s11255-018-02067-0

Cited by 8 publications

(6 citation statements)

References 12 publications

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“…Although the current expert consensus states that PTRA for ARVD with advanced atrophic kidney and/or chronic total occlusion is rarely appropriate (11), several case studies have reported a positive outcome in such patients (16)(17)(18)(19)(20). In the present case, the occlusive lesion appeared to progress during the time when hypertension had suddenly worsened.…”

Section: Discussionmentioning

confidence: 53%

Treatment of Refractory Hypertension with Timely Angioplasty in Total Renal Artery Occlusion with Atrophic Kidney

et al. 2021

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Angioplasty for cases of chronic total occlusion of renal artery with/without atrophic kidney is generally not recommended. We here 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. Timely angioplasty can be beneficial in select patients, even with an atrophic kidney and total occlusion, especially in cases with deterioration of hypertension within six months and the presence of collateral perfusion to the affected kidney.

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Section: Discussionmentioning

confidence: 53%

Treatment of Refractory Hypertension with Timely Angioplasty in Total Renal Artery Occlusion with Atrophic Kidney

et al. 2021

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“…Young patients with TA have been shown to benefit most from revascularization as in our case. 12 Petrov et al 10 studied 7 hypertension individuals aged 15 or older who were on 3 antihypertensive drugs. Similar to our situation, they had an obstructed renal artery with partly sustained subsegmental flow.…”

Section: Discussionmentioning

confidence: 99%

“…Yang et al 12 retrospectively studied 15 consecutive patients with chronic occlusion of the renal artery who had successful PTRA/stenting only for unilateral recurrent occlusion of the renal artery. The restenosis incidence was 20% at a median follow-up of 1.5 years.…”

Section: Discussionmentioning

confidence: 99%

Bail-Out Percutaneous Intervention for Chronic Total Occlusion of the Left Renal Artery Secondary to Takayasu’s Arteritis in a Pediatric Patient Using Drug-Eluting Stent

Jariwala

Jadhav

Madhawar

et al. 2022

Indian Journal of Clinical Cardiology

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Renal-artery stenosis/occlusion is the cause of ischemic nephropathy, which is associated with hypertension due to renovascular system involvement. Acute renal failure in patients with bilateral renal artery stenosis can occur for a variety of reasons, including administration of an angiotensin-converting enzyme inhibitor or spontaneous progression of renal-artery stenosis leading to bilateral total occlusion or high-grade stenosis. Rapid diagnosis and prompt treatment are the basis of kidney survival. The root cause of renal-artery occlusion must be elucidated in younger age patients after revascularization, such as Takayasu’s arteritis (TA) or fibromuscular dysplasia. We discuss the case of a preadolescent girl who had bilateral complete renal artery occlusion due to TA and acute kidney injury, needing renal replacement therapy. She had a bailout percutaneous renal intervention to the left renal artery, which resulted in remarkable clinical improvement.

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“…There are several reports that about 1/4 of patients showed improved renal function following PTRA, while there was no improvement in 1/2 and exacerbation in 1/4 [9,10]. This suggests that renal function should be monitored carefully following PTRA.…”

Section: Discussionmentioning

confidence: 99%

Successful Depressor Effect Concomitant with Complete Normalization of High Renin and Aldosterone Profile by Percutaneous Transluminal Renal Angioplasty in a Patient with Acute Exacerbated Heart Failure with Preserved Ejection Fraction

et al. 2019

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Unusual or unexpected effect of treatment Background: Although the effect of percutaneous transluminal renal angioplasty (PTRA) on clinical outcomes has not been established in previous clinical studies, some case reports showed that PTRA drastically improved patient outcomes. The appropriateness of PTRA should be discussed in detail. Case Report: A 59-year-old man had been on treatment for hypertension for 5 years, but his blood pressure (BP) had been poorly controlled for the past 5 months. He was hospitalized for pulmonary edema due to heart failure with preserved ejection fraction (HFpEF). During hospitalization, ultrasound and plain computed tomography revealed atrophy of the right kidney, and laboratory investigations indicated secondary aldosteronism with high plasma renin activity (PRA). Unenhanced magnetic resonance imaging (MRI) suggested severe stenosis or occlusion of the right renal artery. PTRA was performed for total occlusion at the origin of the right renal artery, resulting in favorable dilation of the vessel and good blood flow. A differential renal vein renin assay showed a right-left difference of PRA before PTRA, but this disappeared after the procedure. Both PRA and the plasma aldosterone concentration were normalized after PTRA. In addition, the patient's BP decreased, proteinuria was reduced, diuretics could be discontinued, and his calcium channel blocker dosage was decreased. Conclusions: The present case suggests that screening for renal artery stenosis by unenhanced MRI may be useful in patients who have HFpEF because PTRA can be used to achieve marked improvement of hypertension, endocrine abnormalities, and heart failure if stenosis is detected.

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Successful endovascular treatment of chronic renal artery occlusion: a preliminary retrospective case series including 15 patients

Cited by 8 publications

References 12 publications

Treatment of Refractory Hypertension with Timely Angioplasty in Total Renal Artery Occlusion with Atrophic Kidney

Treatment of Refractory Hypertension with Timely Angioplasty in Total Renal Artery Occlusion with Atrophic Kidney

Bail-Out Percutaneous Intervention for Chronic Total Occlusion of the Left Renal Artery Secondary to Takayasu’s Arteritis in a Pediatric Patient Using Drug-Eluting Stent

Successful Depressor Effect Concomitant with Complete Normalization of High Renin and Aldosterone Profile by Percutaneous Transluminal Renal Angioplasty in a Patient with Acute Exacerbated Heart Failure with Preserved Ejection Fraction

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