Renal artery stenosis

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This selective renal artery arteriogram demonstrates the string of beads sign, which is characteristic of fibromuscular dysplasia of the renal artery. There are alternating areas of stenosis and aneurysm.

This is the commonest cause of renovascular hypertension in young adults and children. There is a female predominance. The renal arteries are not exclusively involved and the carotid vessels or other aortic branches are also affected, but less commonly than the renal arteries. The mid- and distal portions of the artery are affected whereas in atheromatous disease it is the proximal portion of the artery or the ostium which is involved.

Baloon angioplasty has a 90% success rate with a low restenosis rate (much less than with atheromatous disease).

ACE inhibitors are contraindicated in the treatment of hypertension in patients with renal artery stenosis. Non-steroidal anti-inflammatory drugs should be avoided.

72-year-old male. Pulsatile mass in abdomen

Fig. 2.37 Quiz case.

72-year-old male. Pulsatile mass in abdomen

■ What are the treatment options?

Fig. 2.37 Quiz case.

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Your heart pumps blood throughout your body using a network of tubing called arteries and capillaries which return the blood back to your heart via your veins. Blood pressure is the force of the blood pushing against the walls of your arteries as your heart beats.Learn more...

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