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Renovascular Hypertension (renovascular + hypertension)

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Medical Sciences100%

Selected Abstracts

Diagnosis and Management of Renovascular Disease and Renovascular Hypertension

JOURNAL OF CLINICAL HYPERTENSION, Issue 5 2007
Michael J. Bloch MD
Renovascular disease is a common but complex disorder, the most common causes of which are fibromuscular dysplasia and atherosclerosis. Clinically, it can present as asymptomatic renal artery stenosis, renovascular hypertension, or ischemic nephropathy. Assessing the clinical index of suspicion remains essential in determining an appropriate diagnostic strategy. For diagnosis in patients with suspected fibromuscular disease, it may be reasonable to proceed directly to renal angiography; however, for most patients with suspected atherosclerotic disease, there are a number of noninvasive tests available that can aid in decision making. The choice of the most appropriate initial test should be based on patient characteristics, clinical presentation, and local expertise. Treatment options include medical, surgical, or percutaneous approaches. Generally, in patients with fibromuscular disease, percutaneous intervention provides durable improvement or cure of hypertension. In patients with atherosclerotic disease, the data are less consistent, and there does appear to be a group of patients who will respond well to medical management alone. As technology advances, the diagnostic and treatment paradigms will continue to evolve. [source]

Renovascular hypertension: diagnosis and management

BJU INTERNATIONAL, Issue 5 2005
John O. Connolly
First page of article [source]

Diagnosis and Management of Renovascular Disease and Renovascular Hypertension

JOURNAL OF CLINICAL HYPERTENSION, Issue 5 2007
Michael J. Bloch MD
Renovascular disease is a common but complex disorder, the most common causes of which are fibromuscular dysplasia and atherosclerosis. Clinically, it can present as asymptomatic renal artery stenosis, renovascular hypertension, or ischemic nephropathy. Assessing the clinical index of suspicion remains essential in determining an appropriate diagnostic strategy. For diagnosis in patients with suspected fibromuscular disease, it may be reasonable to proceed directly to renal angiography; however, for most patients with suspected atherosclerotic disease, there are a number of noninvasive tests available that can aid in decision making. The choice of the most appropriate initial test should be based on patient characteristics, clinical presentation, and local expertise. Treatment options include medical, surgical, or percutaneous approaches. Generally, in patients with fibromuscular disease, percutaneous intervention provides durable improvement or cure of hypertension. In patients with atherosclerotic disease, the data are less consistent, and there does appear to be a group of patients who will respond well to medical management alone. As technology advances, the diagnostic and treatment paradigms will continue to evolve. [source]

Estimation of the differential pressure at renal artery stenoses,

MAGNETIC RESONANCE IN MEDICINE, Issue 5 2004
Peter J. Yim
Abstract Atherosclerotic disease of the renal artery can lead to reduction in arterial caliber and ultimately to conditions including renovascular hypertension. Renal artery stenosis is conventionally assessed, using angiography, according to the severity of the stenosis. However, the severity of a stenosis is not a reliable indicator of functional significance, or associated differential pressure, of a stenosis. A methodology is proposed for estimation of the renal artery differential pressure (RADP) from MR imaging. Realistic computational fluid dynamics (CFD) models are constructed from MR angiography (MRA) and phase-contrast (PC) MR. The CFD model is constructed in a semiautomated manner from the MR images using the Isosurface Deformable Model (IDM) for surface reconstruction and a Marching Front algorithm for construction of the volumetric CFD mesh. Validation of RADP estimation was performed in a realistic physical flow-through model. Under steady flow, the CFD estimate of the differential pressure across a stenosis in the physical flow-through model differed by an average of 5.5 mmHg from transducer measurements of the pressure differential, for differential pressures less than 60 mmHg. These results demonstrate that accurate estimates of differential pressure at stenoses may be possible based only on structural and flow images. Magn Reson Med 51:969,977, 2004. Published 2004 Wiley-Liss, Inc. [source]

Three-dimensional visualization of renal artery stenosis by 64-channel multiple detector-row computed tomographical angiography: review of two paediatric cases

ACTA PAEDIATRICA, Issue 3 2010
N Ueda
Abstract Three-dimensional visualization of renal arteries has recently been established by helical contrast-enhanced multiple detector-row computed tomographical angiography (MDCTA) in adults. So far, no information is available on its use in children. We reported two children with renal artery stenosis detected by 64-channel MDCTA. The first patient probably had fibromuscular dysplasia and the other neurofibromatosis type1. The technique showed a left renal artery stenosis with a small left kidney in the first patient and a right renal artery stenosis in the second. Conclusion:, MDCTA is an accurate and noninvasive imaging technique, easily performed in children, and can be used as an alternative diagnostic modality in children with suspected renovascular hypertension. [source]