1/123. Idiopathic supraclinoid and internal carotid bifurcation steno-occlusive disease in young American adults.We report a series of American adults with idiopathic steno-occlusive disease of the supraclinoid internal carotid artery and its bifurcation. We reviewed the clinical records and imaging of 18 patients, 16 women and 2 men, aged 20-53 years (mean 35 years). There were no predominating risk factors for vascular occlusive disease, such as oral contraceptive use, hypertension, diabetes mellitus, or smoking. Four patients had irregularity of their cervical internal carotid arteries in a pattern not classic but suspicious of fibromuscular dysplasia. Eleven patients met the criteria for moyamoya disease, having both bilateral disease and moyamoya collateral lenticulostriate arteries. Necropsy in one case showed intimal thickening with duplication of the internal elastic lamina involving the internal carotid artery bifurcation bilaterally. We found a marked predominance of young and middle-aged females in our American adults, but our findings do not support the association with birth-control pills previously reported.- - - - - - - - - - ranking = 1keywords = hypertension (Clic here for more details about this article) |
2/123. Abdominal aortic coarctation with splanchnic arterial occlusion.Abdominal aortic coarctation is found in only 2% of aortic coarctation and is usually manifested by renovascular hypertension. Splanchnic arterial occlusive lesions occur in 22% of these patients and are exceptionally symptomatic. We present a case report of a young patient with abdominal aortic coarctation causing hypertension and visceral angina. The aetiopathogeny and treatment are discussed.- - - - - - - - - - ranking = 10.753677821299keywords = renovascular, hypertension (Clic here for more details about this article) |
3/123. iliac artery stenosis masquerading as diuretic resistant congestive heart failure.iliac artery stenosis is a rare cause of renal dysfunction in renal allograft recipients. Its presence can mimic renovascular hypertension and yet alter the very radiologic tests used to diagnose renal artery stenosis. We investigate a case of iliac artery stenosis that presented with diuretic resistant fluid overload, hypertension and limb claudication that exposed the pitfalls in the diagnosis and management of this condition. Successful stent placement, 8 months after transplant, resulted in return of the serum creatinine below the post-transplant nadir.- - - - - - - - - - ranking = 10.753677821299keywords = renovascular, hypertension (Clic here for more details about this article) |
4/123. Aortocoronary saphenous vein autograft accidentally attached to a coronary vein: follow-up angiography and surgical correction of the resultant arteriovenous fistula.The fate of aortocoronary saphenous vein bypass graft to the left anterior descending (LAD) coronary vein is reported. The vein graft communicated with the coronary sinus through the proximal LAD vein, producing a functional coronary arteriovenous fistula. The LAD vein was totally occluded distally at follow-up four months after operation. The natural history of congenital fistulas between coronary arteries and the coronary sinus suggested that bacterial endocarditis, pulmonary hypertension, and cardiac failure were all possible future complications in this patient. Operation was performed to revascularize the LAD artery to relieve persistent angina, and to close the fistula. Postoperative angiography showed a patent graft to the LAD artery with complete obliteration of the fistula. The patient is asymptomatic ten months after operation.- - - - - - - - - - ranking = 1keywords = hypertension (Clic here for more details about this article) |
5/123. Concurrent multivessel stenting in a patient with multifocal arterial disease.PURPOSE: To report the concurrent endovascular treatment of multiple stenoses in different vascular territories. methods AND RESULTS: A 45-year-old male presented with an aortic arch syndrome, renovascular hypertension, and leriche syndrome. Intra-arterial digital arteriography disclosed occlusion of the left subclavian artery and stenoses in the left common carotid artery (CCA), the right CCA at the bifurcation, the left renal artery, and both iliac arteries. In a single procedure, the patient received 5 stents in 2 carotid, 1 renal, and 2 iliac arteries. At 3-month follow-up, color flow duplex imaging confirmed continued patency of all stented arteries. CONCLUSIONS: This case illustrates the feasibility, safety, and cost effectiveness of treating multivessel stenoses using a single-session endovascular approach executed by experienced interventionists.- - - - - - - - - - ranking = 9.7536778212994keywords = renovascular, hypertension (Clic here for more details about this article) |
6/123. Bilateral medial frontal infarction in a case of azygous anterior cerebral artery stenosis.We describe the unusual case of a 63-year-old woman with a history of arterial hypertension who presented a sudden weakness of the lower limbs followed by mutism, akinesia and dyspraxia. Magnetic resonance images showed a bilateral medial frontal infarction. Digital subtraction angiography documented a right azygous anterior cerebral artery with severe stenosis in its sub-callosal tract; the left anterior cerebral artery showed mild hypoplasia with only sub-frontal and fronto-polar branches. No embolic source was documented. Afterwards the patient presented a gradual and partial recovery of both motor and cognitive functions.- - - - - - - - - - ranking = 1keywords = hypertension (Clic here for more details about this article) |
7/123. Reduced lung volume associated with acquired pulmonary artery obstruction in children.The effect of postnatal pulmonary artery obstruction on lung growth has not previously been reported. This report describes two patients in whom pulmonary artery banding in early infancy was complicated by complete occlusion of the right pulmonary arter. In each case, the right lung became less voluminous than the left. In one patient, the alevoli of the affected lung were found to be smaller than normal at autopsy. In the other patient, surgical reconstitution of pulmonary arterial flow resulted in a return to normal volume of the affected lung. Observations suggest that pulmonary arterial flow should be restored as early as possible to minimize impairment of lung growth and to avoid irreversible pulmonary hypertension in the opposite lung.- - - - - - - - - - ranking = 1keywords = hypertension (Clic here for more details about this article) |
8/123. hypertension due to renal artery occlusion in a patient with antiphospholipid syndrome.We report an unusual case of renovascular hypertension in a 16-year-old boy with primary antiphospholipid syndrome (PAPS), admitted to our clinic for severe drug-resistant hypertension and hypokalemia. Hormonal investigation revealed secondary aldosteronism and positive captopril test for renovascular disease. aortography confirmed the occlusion of the left renal artery. After nephrectomy, normalization of blood pressure and secondary aldosteronism occurred. Presently the patient remains in good health, receiving warfarin anticoagulant therapy. PAPS is defined by the presence of antiphospholipid antibodies and recurrent thrombosis. Arterial thrombosis (29%) appears to be less prevalent than venous thrombosis. Thrombotic microangiopathy of the kidney is frequently observed but renal artery occlusion, as seen in our patient, is unusual.- - - - - - - - - - ranking = 19.507355642599keywords = renovascular, hypertension (Clic here for more details about this article) |
9/123. Acute occlusion of the left iliac artery after long-distance-running.We report a case of spontaneous iliac occlusion in a 44-year-old male patient after long-distance running. Atherogenic risk factors like hypertension, diabetes, hypercholesterolemia and smoking were missing. Spontaneous iliac occlusion is extremely rare and only a few cases have been documented. Angiography showed occlusion of the left iliac artery with collateral flow via the obturator artery to the common femoral artery. thrombectomy was performed but reocclusion occurred. An iliacofemoral bypass, arterial lysis and bypass thrombectomy was necessary within a few months. At the last follow-up visit two years afterwards the patient was symptom-free. This case indicates that exercise-dependent blood flow disturbances in long-distance-runners could produce changes of the intima.- - - - - - - - - - ranking = 1keywords = hypertension (Clic here for more details about this article) |
10/123. Common iliac artery stenosis presenting as renal allograft dysfunction in two diabetic recipients.BACKGROUND: Suprarenal common iliac artery stenosis is an uncommon but reversible cause of allograft dysfunction in renal transplant recipients. METHOD: We describe two diabetic renal transplant recipients with worsening hypertension, edema, and azotemia. magnetic resonance angiography (MRA) demonstrated tight stenoses in the common iliac artery proximal to the allograft anastomosis site with patent renal transplant artery in both cases. These findings were later confirmed with carbon dioxide angiography. RESULTS: No acute rejection was noted on renal biopsy in either case. Placement of percutaneous iliac artery Wallstents resulted in decrease of serum creatinine from 6.5 to 2.0 mg/dl and 1.7 to 1.0 mg/dl within 2 and 4 weeks, respectively. CONCLUSION: Common iliac artery stenosis should be suspected in renal transplant recipients presenting with worsening hypertension, edema and azotemia. MRA for screening followed by carbon dioxide angiography and placement of intravascular stents for focal vascular obstructive lesions reverses allograft dysfunction.- - - - - - - - - - ranking = 2keywords = hypertension (Clic here for more details about this article) |
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