| Case Studies: |
| Case 01: |
Young girl (18 yrs) with Blood pressure of 220/120 mm Hg
A
young college going student presented with severe headaches and blurring of vision.
Examination revealed very high blood pressure. Kidney function was normal. Renal
artery Doppler demonstrated a severe stenosis of the mid segment of the right
renal artery. Balloon angioplasty was performed to this narrowing, with excellent
result, and immediate normalization of the blood pressure. In young patients,
Fibromuscular dysplasia is the most common cause of renal artery narrowing. Since
this is an inflammatory condition, stenting is usually not indicated in this type
of disease. Long term results are quite encouraging. |
 |
| |
 |
|
|
| Case
02: |
Elderly Man With Hypertension
and Abnormal Renal function
A 70 year old man presented with progressive
rise in blood pressure and an elevated serum creatine level of 2.2 mg %. Multiple
anti hypertensive drugs failed to control the high blood pressure. Renal artery
Doppler study confirmed presence of critical stenosis of lower left renal artery.
Angioplasty and stenting of this artery was performed. The blood pressure was
now brought under control, and renal function also improved.
In elderly
patients, the commonest cause of stenosis is atherosclerosis. Usually there may
be associated calcification. It is therefore essential to implant a stent in these
cases, to prevent restenosis. |
 |
| |
|
|
|
| Case
03: |
Stenting
of Main Renal Artery
This 75 year old woman presented with severe headache
of one months duration. She was found to have severe recent onset hypertension.
Doppler ultrasound suggested renal artery stenosis, which was confirmed by angiography.
She underwent balloon dilatation and placement of stent in the renal artery, with
immediate relief of the high blood pressure.
|
| |
|
|
|
| Case
04: |
Angioplasty
in Only Surviving Kidney
This 85 year old lady presented to a Nephrologist
with a diagnosis of severe hypertension and renal failure, with a serum creatinine
level of 6 mg%. Investigations by ultrasound Doppler revealed a occluded right
renal artery and a severe 95% Stenosis of the right renal artery. The lady underwent
successful angioplasty and stenting of the only surviving left renal artery. Within
a week, the blood pressure was normalized without the need for any antihypertensive
medications, and within one month the serum creatinine was normalized to 1.3 mg
%.
|
|