Humans ; Renal Artery Obstruction ; therapy ; Stents

Humans ; Renal Artery ; Constriction, Pathologic ; Hypertension, Renovascular/therapy* ; Vascular Diseases ; Renal Artery Obstruction/therapy* ; Embolization, Therapeutic

Aged ; Female ; Humans ; Male ; Middle Aged ; Renal Artery ; drug effects ; Renal Artery Obstruction ; drug therapy ; Retrospective Studies ; Thrombolytic Therapy ; methods

Atherosclerotic renal artery stenosis (RAS) usually involves the ostium and the proximal one-third of the renal artery main branch. Percutaneous renal artery angioplasty with stent placement is a well recognized treatment for atherosclerotic RAS. Occasionally, atherosclerotic RAS involves renal artery bifurcations. However, stent implantation in atherosclerotic RAS involving bifurcation is not only troublesome, but also challenging because of side branch occlusion and in-stent restenosis (ISR). In the present report, we describe the use of drug-eluting stents (DES) with provisional T-stenting technique for the treatment of renal artery bifurcation lesion. Follow-up angiogram showed no significant ISR 18 months after the procedure. In the treatment of renal bifurcation lesions, a two-stent strategy using DES could be a viable option in selected patients.
Aged ; *Angioplasty ; *Drug-Eluting Stents ; Humans ; Male ; Renal Artery/pathology/radiography ; Renal Artery Obstruction/pathology/*therapy ; Treatment Outcome

Acute thrombotic renal artery occlusion is rarely identified at premortem. Early diagnosis and treatment are crucial for salvage of renal function. We reported a case of successfully dissolved acute thrombotic occlusion of renal artery of 9 hour duration with intra-arterial infusion of urokinase in a 83-year-old man.
Aged, 80 and over ; Early Diagnosis ; Humans ; Infusions, Intra-Arterial ; Renal Artery Obstruction ; Renal Artery* ; Thrombolytic Therapy ; Urokinase-Type Plasminogen Activator*

BACKGROUNDTransfemoral artery access is the main approach for the interventional treatment of renal artery stenosis (RAS). This study aimed to investigate the technical feasibility of a transradial interventional (TRI) treatment of renal artery stenosis.

METHODSA series of 23 patients who underwent transradial renal artery stenting from October 2010 to October 2011 were studied. Radial sheath system (Terumo, Japan) was used to get access to the radial artery. Radial tourniquet (Terumo) was used to stop bleeding. A 5Fr MPA (COOK, USA) was used to perform selective renal arteriography. Percutaneous renal artery stent systems were used to perform renal artery stenting.

RESULTSRenal artery angiography showed that 15 patients had unilateral renal artery stenosis and eight patients had bilateral renal artery stenosis. The descending aorta could not be catheterized in one patient because of the type III aortic arch. Twenty-two patients successfully underwent transradial renal artery angiography and the technical success rate was 95.7%. There was no puncture site hematoma or pseudoaneurysm. Mean procedure time was (38.4 ± 7.2) minutes, the mean amount of contrast agent used was (93.2 ± 6.3) ml, and the mean postprocedure bleeding time was (3.2 ± 1.9) minutes.

CONCLUSIONTransradial renal artery intervention is technically reliable with less invasion, rapid recovery, fewer complications and may become an alternative intervention approach for the treatment of renal artery stenosis.

Aged ; Angiography ; Angioplasty ; methods ; Female ; Humans ; Male ; Middle Aged ; Renal Artery ; diagnostic imaging ; Renal Artery Obstruction ; diagnostic imaging ; therapy

OBJECTIVETo study the effects of percutaneous renal artery intervention on renal function and blood pressure in patients with renal artery stenosis.

METHODSEighty-seven patients with severe uni- or bi-lateral renal artery stenosis (luminal diameter narrowing >/= 70%) and clinical hypertension received renal artery stenting between January 2002 and December 2002. The changes in blood pressure and serum creatinine level and creatinine clearance (CCr) 48 hours after intervention and during 6 months of follow-up were assessed.

RESULTSRenal stenting was performed in 98 stenotic arteries of 87 patients, and the procedural success rate was 100%. Serum creatinine level was slightly elevated from (176 +/- 21) micro mol/L to (179 +/- 11) micro mol/L (P = 0.15) 48 hours after the procedure, but significantly decreased to (149 +/- 15) micro mol/L at 6 months (P < 0.001). CCr was also greatly improved [(37 +/- 11) ml/min before versus (51 +/- 8) ml/min at 6 months, P < 0.001]. During follow-up, 61% of the patients experienced a normal renal function. Despite conventional medical treatment, systolic and diastolic blood pressures were also significantly decreased after stenting [(163 +/- 23)/(96 +/- 13) mm Hg before versus (148 +/- 12)/(79 +/- 15) mm Hg at 6 months, all P < 0.001], and hypertension was well controlled in 67% of the patients at 6 months' follow-up.

CONCLUSIONRenal artery stenting has a high success rate and is effective in improving renal function and blood pressure for patients with severe renal artery stenosis.

Aged ; Arteriosclerosis ; physiopathology ; therapy ; Blood Pressure ; Female ; Humans ; Hypertension, Renal ; physiopathology ; therapy ; Kidney ; physiopathology ; Male ; Renal Artery ; Renal Artery Obstruction ; physiopathology ; therapy ; Stents

Angioplasty, Balloon ; methods ; Atherosclerosis ; pathology ; therapy ; Humans ; Hypertension ; complications ; drug therapy ; Renal Artery Obstruction ; etiology ; therapy ; Stents

OBJECTIVETo analyze the value of fractional flow reserve (FFR) measurement on endovascular therapy for patients with renal artery stenosis.

METHODSClinical data of 9 patients underwent endovascular therapy due to moderate renal artery stenosis (50%-69%) in Anzhen hospital from May to September 2013 were retrospectively analyzed. Fractional flow reserve (FFR) were measured in patients with moderate stenosis in renal artery and abnormal glomerular filtration rate (GFR) or different between renal artery angiography and ultrasound before the procedure. Endovascular therapy was not applied for patients with FFR > 0.90, and the patients were subsequently followed up clinically. Endovascular therapy was applied in patients with FFR less than 0.90 or the pressure difference between the two ends of stenosis was more than 20 mmHg (1 mmHg = 0.133 kPa). Blood pressure, ultrasound and contrast-enhanced ultrasonography data were obtained at 1 and 3 months later, respectively.

RESULTSThere were 6 patients diagnosed as severe renal artery stenosis (≥ 70%) and the other 3 patients diagnosed as moderate renal artery stenosis by renal artery ultrasound before operation. Two patients with FFR > 0.90 were not undertaken the endovascular therapy. Seven patients with FFR < 0.90 underwent endovascular therapy. After renal artery stenting, renal stenosis was relieved immediately and the transstent blood flow was fluency in these 7 patients. There was significant difference in the FFR before and after operation (0.81 ± 0.09 vs.0.94 ± 0.03, P = 0.008). Among the patients underwent endovascular therapy, blood pressure was normal without medication in 2 patients and well controlled with 1 or 2 combined antihypertensive drugs in the rest 5 patients.

CONCLUSIONIn patients with moderate renal artery stenosis, fractional flow reserve measurement could be used as a useful index to guide intervention procedure and to evaluate the efficacy of endovascular therapy.

Angiography ; Constriction, Pathologic ; therapy ; Fractional Flow Reserve, Myocardial ; Hemodynamics ; Humans ; Renal Artery ; diagnostic imaging ; Renal Artery Obstruction ; therapy ; Retrospective Studies ; Stents ; Ultrasonography

OBJECTIVE: To investigate the effect of bone marrow mesenchymal stem cells (BMSCs) on ureteral injury repair via renal artery transplantation. METHODS: The left ureteral obstruction model was set up in 49 Balb/c mice by micro vascular clamp. The microscopic vascular clamp was taken out to lift the left ureteral obstruction after 10 days. The mice were randomly divided into an experimental group (n=25) and a control group (n=24). Balb/c mice BMSCs transfected by luciferase (Luc) were transplanted immediately through the renal artery after removing the microscopic vascular clamp from the experimental group; while mice in the control group was closed the incision after the microscopic vascular clamp was removed immediately and without BMSCs transplant. Magnetic resonance imaging (MRI) was used to scan the experimental mice. By measuring the left renal pelvis volume of the experimental mice at different time points and comparing the left ureter recanalization rate after removing left ureteral obstruction of the experimental group and the control group, we evaluated the repair effect of BMSCs on ureteral injury. RESULTS: The volume of the left renal pelvis in experimental mice became bigger obviously after the left ureter was obstructed (P<0.01). The left renal pelvis volume of the experimental group and the control group had no statistical significance 10 days after the left ureteral obstruction was set up (P=0.693). In the experimental group, the left ureter recanalization rate was higher than that in the control group, after removing the left ureteral obstruction (P=0.012). CONCLUSION Transplantation through the renal artery can promote the restoration of ureteral injury in mice.
Animals ; Hematopoietic Stem Cell Transplantation ; methods ; Hematopoietic Stem Cells ; cytology ; Mice ; Mice, Inbred BALB C ; Renal Artery ; Ureteral Obstruction ; therapy