Difficulty and importance of diagnosing stenosis of renal branch artery in fibromuscular dysplasia: a case report.

IF 1.8 4区 医学
Blood Pressure Pub Date : 2021-12-01 Epub Date: 2021-10-26 DOI:10.1080/08037051.2021.1993735
Andreas Skræddergaard, Jakob Nyvad, Kent Lodberg Christensen, Arne Hørlyck, Hossein Mohit Mafi, Mark Reinhard
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引用次数: 2

Abstract

A 16-year-old patient presented with abdominal pain and sustained hypertension. Thorough evaluation including renography with and without captopril and renal vein renin sampling were normal. Duplex ultrasound, however, raised suspicion of a renal artery stenosis. This was confirmed by computed tomography angiography which showed a severe branch artery stenosis with post-stenotic dilatation consistent with focal fibromuscular dysplasia (FMD). As the hypertension was resistant to 3 classes of antihypertensive treatment, percutaneous transluminal renal angioplasty (PTRA) was offered. The procedure had immediate effect on the blood pressure. Without medication the patient remains normotensive 4 years after and the abdominal pain has only sporadically returned. The presented case illustrates the challenging process of diagnosing FMD-related renal branch artery stenosis as well as the potential benefits of PTRA in this patient group.

纤维肌肉发育不良患者肾支动脉狭窄诊断的困难与重要性1例。
一个16岁的病人表现为腹痛和持续高血压。全面的评估包括使用和不使用卡托普利的肾脏造影和肾静脉肾素取样均正常。双相超声提示肾动脉狭窄。计算机断层血管造影证实了这一点,显示了严重的分支动脉狭窄,狭窄后扩张与局灶性纤维肌肉发育不良(FMD)一致。由于高血压对3种降压治疗均有抵抗性,故给予经皮腔内肾血管成形术(PTRA)治疗。手术对血压有立竿见影的效果。在没有药物治疗的情况下,患者4年后血压保持正常,腹痛只是偶尔复发。本病例说明了诊断fmd相关肾分支动脉狭窄的挑战性过程以及PTRA在该患者组中的潜在益处。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Blood Pressure
Blood Pressure Medicine-Cardiology and Cardiovascular Medicine
CiteScore
3.20
自引率
5.60%
发文量
41
期刊介绍: For outstanding coverage of the latest advances in hypertension research, turn to Blood Pressure, a primary source for authoritative and timely information on all aspects of hypertension research and management. Features include: • Physiology and pathophysiology of blood pressure regulation • Primary and secondary hypertension • Cerebrovascular and cardiovascular complications of hypertension • Detection, treatment and follow-up of hypertension • Non pharmacological and pharmacological management • Large outcome trials in hypertension.
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