1/63. Staged thoracic and abdominal aortic aneurysm repair using stent graft technology and surgery in a patient with acute renal failure.A 52-year-old male presented with severe hypertension and acute renal failure. carbon dioxide (CO(2)) angiography identified a saccular thoracic aortic aneurysm, right renal artery stenosis, left renal artery occlusion, an infrarenal aortic aneurysm, celiac artery, and inferior mesenteric artery (IMA) orificial stenoses. Via an anterior retroperitoneal approach, bilateral renal artery thromboendarterectomy, infrarenal aortic aneurysmectomy, and IMA reimplantation were performed. The patient's tortuous iliac arteries were straightened to permit future passage of a thoracic stent graft by mobilizing the aortic bifurcation and anastomosing it to a Dacron graft within 4 cm of the renal vessels. Two weeks later, a stent graft was placed via a femoral incision utilizing CO(2) angiography, successfully excluding the saccular thoracic aneurysm. Recovery from both procedures was quick, with rapid return of renal function, and alleviation of the hypertension. At 8 months follow-up, his renal arteries and aorta are patent.- - - - - - - - - - ranking = 1keywords = aneurysm (Clic here for more details about this article) |
2/63. magnetic resonance imaging for early detection of takayasu arteritis.The patient was a 15-year-old girl with suspected takayasu arteritis. Magnetic resonance (MR) imaging, using the fast low angle shot (FLASH) technique, revealed aneurysmal dilation of the aortic root and irregular thickening of the aortic wall. Three-dimensional (3-D) contrast-enhanced MR angiography successfully demonstrated narrowing of the left carotid and left subclavian arteries. In addition, 2-dimensional (2-D) FLASH MR imaging clearly visualized narrowing of two right renal arteries and the left renal artery. These were angiographically evident. Thus, MR imaging is particularly useful for early detection of subtle arteritic changes and involvement of stenotic lesions in branch vessels in the early phase of takayasu arteritis.- - - - - - - - - - ranking = 0.125keywords = aneurysm (Clic here for more details about this article) |
3/63. A case of renovascular hypertension due to bilateral renal artery microaneurysm who succeeded in baby delivery.We report the case of a young pregnant woman with bilateral renovascular hypertension due to renal microaneurysms from an unknown cause, who had a successful delivery. pregnancy did not affect the disease activity even in the postpartum period. Her blood pressure was maintained within the normal range by administration of labetalol. Although the angiographic appearance of the symmetrical aneurysms in both renal artery beds from the interlobular to arcuate artery levels suggested polyarteritis nodosa of multiple microaneurysms in the bilateral interlobular arteries, the clinical features suggested other causes of renovascular hypertension, such as fibromuscular dysplasia and/or congenital microaneurysms. We were thus unable to reach a definitive diagnosis.- - - - - - - - - - ranking = 1keywords = aneurysm (Clic here for more details about this article) |
4/63. Renovascular hypertension associated with neurofibromatosis: two cases and review of the literature.The authors report two cases of renovascular hypertension associated with neurofibromatosis. A 19-year-old woman was admitted to our hospital with a complaint of abdominal pain and blood pressure of 180/120 mmHg. Examination revealed cafe-au-lait spots over her chest and extremities. Peripheral plasma renin activity (PRA) under basal conditions was 2.8 ng/ml/h and increased to 12.6 ng/ml/h after administration of 50 mg captopril. plasma and urinary catecholamines were normal. Selective renal angiography showed left aneurysmal dilatation of the segmentary branch and right renal artery stenosis with multiple aneurysmal affecting different branches. blood pressure was controlled by multiple drugs, including beta-blockers and angiotensin-converting enzyme inhibitor. Another patient, a 20-year-old woman, was admitted because of severe arterial hypertension, numerous cafe-au-lait spots, scoliosis, and mass over the right arm. PRA from the right renal vein was extremely elevated, and selective angiography demonstrated bilateral renal artery stenosis. Aortorenal bypass was performed successfully.- - - - - - - - - - ranking = 0.25keywords = aneurysm (Clic here for more details about this article) |
5/63. Midaortic syndrome in childhood associated with a ruptured cerebral aneurysm: a case report.BACKGROUND: We present a patient with a midaortic syndrome who presented with subarachnoid hemorrhage caused by rupture of an anterior communicating artery aneurysm.CASE DESCRIPTION: A 14-year-old boy with midaortic syndrome was admitted to our hospital because of subarachnoid hemorrhage due to rupture of an anterior communicating artery aneurysm. He also developed acute renal failure due to previously controlled hypotension. After blood dialysis, successful clipping of the aneurysm was performed. The postoperative course was complicated by malignant renovascular hypertension due to midaortic syndrome. Medical treatment failed to control his hypertension; left primary nephrectomy improved his condition.CONCLUSION: Although midaortic syndrome is rare, it may be significant as a cause of cerebral hemorrhage in childhood.- - - - - - - - - - ranking = 0.875keywords = aneurysm (Clic here for more details about this article) |
6/63. renal artery stenosis and aneurysmatic dilatation of arteria carotis interna in tuberous sclerosis complex.hypertension in children with neurocutaneous disorders (phacomatoses) is a well-recognized complication of these diseases and the cause of hypertension is fairly specific within each group. In patients with neurofibromatosis, hypertension is mainly caused by renovascular disease, whereas in tuberous sclerosis (TSC) reasons for hypertension are renoparenchymal lesions, such as angiomyolipoma or cysts. We report on a girl with TSC and hypertension due to unilateral renal artery stenosis associated with aneurysmatic changes of internal carotid artery. This unusual combination of symptoms in our patient supports the importance of thorough and complete investigation of hypertension in children with phacomatoses.- - - - - - - - - - ranking = 0.625keywords = aneurysm (Clic here for more details about this article) |
7/63. renal artery stenosis associated with saccular aneurysm and arterio-venous fistula.A 25-year-old female presented with uncontrolled hypertension due to renal artery stenosis, a saccular aneurysm at the mid-shaft of the right renal artery, and an arterio-venous fistula distal to the aneurysm. Stent-graft implantation via the percutaneous approach was successfully used to treat this complex pathology.- - - - - - - - - - ranking = 0.75keywords = aneurysm (Clic here for more details about this article) |
8/63. Renovascular hypertension secondary to spontaneous renal artery dissection and treatment with stenting.Renovascular disease is the cause of less than 1% of patients with hypertension; within this group aneurysm and dissection in renal artery are even rarer causes. It may be not only iatrogenic or traumatic, but may also develop spontaneously from fibromuscular disease or atherosclerotic lesions. We present a 26-year-old male patient with recently developed and progressive hypertension in whom renal angiography showed aneurysmal dilatation and dissection of the right renal artery. With the implantation of two stents in the true lumen, normal renal blood flow and thrombosis of the aneurysmal sac was established. As a result, stent implantation to renal artery dissection is effective, reliable and easy and can be an alternative to surgical treatment.- - - - - - - - - - ranking = 0.375keywords = aneurysm (Clic here for more details about this article) |
9/63. A large unilateral renal artery aneurysm in a young child.The case of a 13-month-old boy with fibromuscular dysplasia (FMD) presenting with a large saccular aneurysm of the left renal artery and renovascular hypertension is reported. Renal and intrarenal arteries showed numerous small aneurysms alternating with stenoses. All arterial lesions were localized to the left kidney. After left nephrectomy, the patient's blood pressure normalized. Histopathologic examination of the arteries disclosed changes typical of medial fibroplasias, the most frequently described form of FMD in children. This diagnosis is rewarding as it represents a surgically curable cause of severe hypertension.- - - - - - - - - - ranking = 0.75keywords = aneurysm (Clic here for more details about this article) |
10/63. hypertension due to an aneurysm of the left renal artery in a patient with neurofibromatosis.Arterial lesions in patients with neurofibromatosis are rarely described and in most cases are stenotic. The aneurysmal changes reported in the literature are usually characterized by multiple microaneurysms due to the dysplastic lesions of the artery. We report a case of a single aneurysm of the inferior hilar branch of the left renal artery of a young female with neurofibromatosis. The patient showed hypoperfusion of the renal pole fed by this branch and was hypertensive. The aneurysm had a diameter of 4 cm and showed the histological findings typical of dysplastic lesions of neurofibromatosis. The hypertension and the renal pole hypoperfusion recovered after surgical excision of the aneurysm and end-to-end anastomosis of the hilar branch stumps.- - - - - - - - - - ranking = 1.125keywords = aneurysm (Clic here for more details about this article) |
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