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Renal artery stenosis (RAS) is the narrowing of one or both of the renal arteries, most often caused by atherosclerosis or fibromuscular dysplasia.This narrowing of the renal artery can impede blood flow to the target kidney, resulting in renovascular hypertension – a secondary type of high blood pressure.
Renal artery stenosis, or narrowing of one or both renal arteries will lead to hypertension as the affected kidneys release renin to increase blood pressure to preserve perfusion to the kidneys. RAS is typically diagnosed with duplex ultrasonography of the renal arteries. It is treated with the use of balloon angioplasty and stents, if necessary.
Renal infarction is a medical condition caused by an abrupt disruption of the renal blood flow in either one of the segmental branches or the major ipsilateral renal artery. [3] Patients who have experienced an acute renal infarction usually report sudden onset flank pain , which is often accompanied by fever , nausea , and vomiting .
Relative to surgery, angioplasty is a lower-risk option for the treatment of the conditions for which it is used, but there are unique and potentially dangerous risks and complications associated with angioplasty: Embolization, or the launching of debris into the bloodstream [24]
Emergency bypass surgery for the treatment of an acute myocardial infarction (MI) is less common than PCI or thrombolysis. From 1995 to 2004, the percentage of people with cardiogenic shock treated with primary PCI rose from 27.4% to 54.4%, while the increase in coronary artery bypass graft surgery (CABG) was only from 2.1% to 3.2%. [34]
The first surgical treatment is thought to be performed by R.S. Shaw and described in the New England Journal of Medicine in 1958. The procedure Shaw described is referred to as mesenteric endarterectomy. [18] Since then, many advances in treatment have been made in minimally invasive, endovascular techniques including angioplasty and stenting.
The most advantageous aspect is very low access-site bleeding complications even with aggressive use of anticoagulation and antiplatelet therapies. [ 7 ] [ 8 ] During the angioplasty and stent procedures patients are given therapeutic (high) doses of anticoagulation (blood thinners) and platelet inhibiting medications.
Renal replacement therapy includes dialysis (hemodialysis or peritoneal dialysis), hemofiltration, and hemodiafiltration, which are various ways of filtration of blood with or without machines. Renal replacement therapy also includes kidney transplantation, which is the ultimate form of replacement in that the old kidney is replaced by a donor ...