TY - JOUR
T1 - Total Renal Artery Occlusion
T2 - Recovery of Function After Revascularization
AU - Manohar, Sandhya
AU - Hamadah, Abdurrahman
AU - Herrmann, Sandra M.
AU - Textor, Stephen C.
N1 - Publisher Copyright:
© 2018 National Kidney Foundation, Inc.
PY - 2018/5
Y1 - 2018/5
N2 - Current trends in managing atherosclerotic renal artery stenosis favor medical therapy, on account of negative results from prospective trials of revascularization, such as CORAL and ASTRAL. One result of this trend has been encountering occasional patients with progressive disease, sometimes leading to total arterial occlusion. We illustrate a case of accelerated hypertension with complete renal artery occlusion in which the patient recovered function after surgical bypass and we review the clinical approach used and the advanced imaging modalities available to us. A high index of suspicion and careful radiologic imaging play important roles in selecting patients who may have residual function and may benefit from revascularization. This case illustrates an example whereby restoring renal artery perfusion for carefully selected patients can be life changing, with recovery of kidney function and improved blood pressure, pill burden, and overall quality of life.
AB - Current trends in managing atherosclerotic renal artery stenosis favor medical therapy, on account of negative results from prospective trials of revascularization, such as CORAL and ASTRAL. One result of this trend has been encountering occasional patients with progressive disease, sometimes leading to total arterial occlusion. We illustrate a case of accelerated hypertension with complete renal artery occlusion in which the patient recovered function after surgical bypass and we review the clinical approach used and the advanced imaging modalities available to us. A high index of suspicion and careful radiologic imaging play important roles in selecting patients who may have residual function and may benefit from revascularization. This case illustrates an example whereby restoring renal artery perfusion for carefully selected patients can be life changing, with recovery of kidney function and improved blood pressure, pill burden, and overall quality of life.
KW - Atherosclerotic renovascular disease (ARVD)
KW - blood oxygen level-dependent magnetic resonance (BOLD-MR)
KW - case report
KW - hypertension
KW - imaging
KW - renal artery stenosis
KW - renal ischemic disease
KW - revascularization
KW - total renal artery occlusion
UR - http://www.scopus.com/inward/record.url?scp=85041493949&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85041493949&partnerID=8YFLogxK
U2 - 10.1053/j.ajkd.2017.11.014
DO - 10.1053/j.ajkd.2017.11.014
M3 - Article
C2 - 29429749
AN - SCOPUS:85041493949
SN - 0272-6386
VL - 71
SP - 748
EP - 753
JO - American Journal of Kidney Diseases
JF - American Journal of Kidney Diseases
IS - 5
ER -