Histologic and morphologic character of pediatric renal artery occlusive disease.

Objective: The pathologic nature of pediatric renal artery occlusive lesions causing renovascular hypertension has been the subject of numerous anecdotal reports. This study was undertaken to define the character of childhood renal artery stenoses. A better understanding of this disease is particularly germane, given its unknown etiology and the limited success of certain contemporary treatment options.

Spontaneous Coronary Artery Dissection: Mechanisms, Diagnosis and Management.

Spontaneous coronary artery dissection (SCAD) is a relatively infrequent cause of acute coronary syndrome that usually affects young to middle-aged women. Mainly because of its low prevalence, until recently, most of the evidence on this condition was derived from case reports and small series. Over the last 5 years, more robust evidence has become available from larger retrospective and prospective cohorts of patients with SCAD.

Clinical features and prognosis of patients with spontaneous coronary artery dissection.

There have been inconsistent reports regarding the clinical features and characteristics of patients diagnosed with spontaneous coronary artery dissection (SCAD). In addition, predictors of mortality in SCAD patients are unknown. We evaluated the prevalence, clinical characteristics, medical management, and predictors of in-hospital mortality of SCAD-related hospitalizations using data from a single health care system from January 1, 2008, to December 31, 2018.

Impact of Percutaneous Revascularization on Left Ventricular Mass and Its Relationship to Outcome in Hypertensive Patients With Renal Artery Stenosis.

Background: We investigated the effects of percutaneous transluminal renal angioplasty on left ventricular (LV) mass, and the impact of LV mass reduction on outcomes.

Methods: A total of 144 hypertensive patients with renal artery stenosis (RAS) (mean age 69 years; 22.2% fibromuscular dysplasia (FMD)) who underwent angioplasty were included.

Spontaneous Coronary Artery Dissection in a Liver Transplantation Candidate.

Spontaneous coronary artery dissection (SCAD) is an uncommon and potentially fatal cause of acute coronary syndrome, myocardial infarction, and sudden death primarily affecting women. While the exact cause of SCAD is unknown, associated risk factors are emotional or physical stress, female gender, pregnancy-related factors including hormonal changes, fibromuscular dysplasia, mixed connective tissue disorders, and inflammatory disorders. In this report, we present a middle-aged female with ulcerative colitis and cirrhosis secondary to primary sclerosing cholangitis who was found to have SCAD on cardiac evaluation for liver transplantation workup.

A simple, refined approach to diagnosing renovascular hypertension in children: A 10-year study.

Background: Despite advances in non-invasive vascular imaging, detection of renal artery stenosis via catheter angiography is the criterion standard for the diagnosis of renovascular hypertension (RVH). However, because of lack of evidence, the utility of various blood tests and imaging modalities remains unclear.

Methods: We retrospectively analyzed the utility of blood tests (plasma renin activity [PRA], aldosterone, and renal vein renin [RVR] values) and imaging studies (computed tomography angiography [CTA], kidney ultrasonography [US]) by comparing them with catheter angiography.

Systematic and Multidisciplinary Evaluation of Fibromuscular Dysplasia Patients Reveals High Prevalence of Previously Undetected Fibromuscular Dysplasia Lesions and Affects Clinical Decisions: The ARCADIA-POL Study.

Fibromuscular dysplasia (FMD), regarded as a generalized vascular disease, may affect all vascular beds and may result in arterial stenosis, occlusion, aneurysm, or dissection. It has been proposed to systematically evaluate all vascular beds in patients with FMD, regardless of initial FMD involvement. However, the impact of this approach on clinical decisions and on management is unknown.

How to Repair Non-Atheromatous Carotid Lesions.

Non-atheromatous surgical lesions are estimated to represent at most 10% of all carotid procedures, most of which involve atheromatous lesions. Isolated tortuosity of the carotid vessels is sometimes treated surgically. The pathologies most frequently studied are extra-cranial carotid aneurysms, dissections, and fibromuscular dysplasia.

Fibromuscular dysplasia presenting with a deep vein thrombosis.

A 41-year-old male patient presented with isolated right lower limb swelling. An ultrasound scan showed right external iliac and femoral vein deep vein thrombosis due to extrinsic compression by an aneurysm of the right common iliac artery. Investigations including imaging and a tissue biopsy of right and left femoral arteries confirmed a rare clinical presentation of fibromuscular dysplasia involving iliac, coeliac, renal and pulmonary vessels.

Efficacy of Antihypertensive Therapy in a Child with Unilateral Focal Fibromuscular Dysplasia of the Renal Artery: A Case Study and Review of Literature.

: Fibromuscular dysplasia (FMD) is one of the important etiologies of renovascular hypertension in children. It is usually resistant to multiple antihypertensive agents and can cause extreme elevation in blood pressures, which can lead to end organ damage if not promptly diagnosed and treated. Treatment options include medical management with antihypertensive agents, balloon or stent angioplasties, surgical revascularization, and nephrectomy.

Progesterone receptor expression in fibromuscular dysplasia: A report of two unusual cases.

Fibromuscular dysplasia is rarely biopsied. Progesterone receptor expression in myofibroblastic cells is useful for the histopathological evaluation in difficult-to-diagnose cases. Herein, we report two unusual cases of fibromuscular dysplasia in which progesterone receptor expression was shown in vessel sections.

[Bilateral renal infarction: A rare complication of fibromuscular dysplasia].

Bilateral renal infarction complicating Fibromuscular Dysplasia (FMD) is extremely rare and has so far been reported only in a handful of cases. We report a 44-year-old man who presented with complaints of abdominal pain and severe hypertension. Computed tomography of the abdomen revealed bilateral renal infarction and a renal angiography confirmed the bilateral and irregular stenosis due to FMD, in the absence of systemic vasculitis and other risk factors for thromboembolic events.

Isolated Renal Artery Dissection: A Systematic Review of Case Reports.

Isolated renal artery dissection (IRAD) is a rare and often unrecognized clinical entity, with a paucity of data on its epidemiology and management. We extracted 129 cases of IRAD from the medical literature between 1972 and 2016. IRAD as a result of an extended dissection from the aorta and splanchnic or mesenteric arteries was excluded.

Unexpected presentation and surgical salvage of transplant renal artery dissection caused by vascular clamping: a case report.

Background: Transplant renal artery dissection is a rare and serious event that can cause allograft dysfunction and activation of the renin-mediated renovascular hypertension. Most cases are induced by percutaneous transluminal angioplasty, arteriosclerotic disease, or fibromuscular dysplasia. We observed a case of transplant renal artery dissection induced by unusual causes during kidney transplantation.

Intractable coronary fibromuscular dysplasia leading to end-stage heart failure and fatal heart transplantation.

Coronary fibromuscular dysplasia is uncommon, and even rarer its unstable and recurrent course. We present the unique case of a 52-year-old woman who underwent in total 12 coronary angiographies and three percutaneous coronary intervention within 24 months because of repetitive acute coronary syndromes due to refractory spasm, dissection, restenosis all leading to end-stage heart failure, and heart transplantation. The patient died 12 days after the heart transplantation complicated by intraoperative acute thrombotic occlusion of left anterior descending artery of the graft despite normal pretransplant coronary angiography.

Percutaneous transluminal angioplasty with selective stenting for the treatment of renal artery stenosis caused by fibromuscular dysplasia: 18 years' experience from the China Center for Cardiovascular Disease.

Objectives: This study aimed to evaluate the safety and efficiency of percutaneous transluminal angioplasty (PTA) with selective stenting treating Chinese patients with renal artery stenosis (RAS) due to fibromuscular dysplasia (FMD).

Background: Endovascular data of patients with RAS caused by FMD are scarce in China.

Methods: Clinical data of 105 hypertensive patients with RAS caused by FMD underwent endovascular therapy at a single-site between June 2001 and October 2018 were analyzed retrospectively.

Detection of significant left renal artery stenosis caused by fibromuscular dysplasia with selective angiography.

A 22-year-old female, was referred with a history of a headache and elevated blood pressure without family history of hypertension or familial dyslipidemia. Initially, a spiral computed tomographic angiography of the renal arteries was conducted, demonstrating completely abnormal left renal artery at the medial portion of the vessel with suspicious stenosis, which was supposed to be due to fibromuscular dysplasia (FMD). Subsequently, the patient underwent selective renal angiography and balloon angioplasty.

New-Onset Uncontrolled Hypertension and Renal Failure in a Young Woman.

This report describes the case of a previously healthy 30-year-old woman who presented with uncontrolled hypertension and renal failure. This case emphasizes the importance of considering renal artery disease. The differential diagnosis for renal artery stenosis is discussed, and the diagnosis and management of Takayasu's arteritis in this patient are highlighted.

Lung Transplantation for Bronchopulmonary Dysplasia in Adults: A Clinical and Pathologic Study of 3 Cases.

Bronchopulmonary dysplasia (BPD) is usually seen in premature infants who require mechanical ventilation and oxygen therapy for acute respiratory distress. Although most patients wean from oxygen therapy by the ages of 2 to 3, rehospitalization for respiratory problems is common in these patients in adulthood. There have been few studies that document the long-term outcomes of BPD survivors and information about the pulmonary function and radiographic findings of adult BPD are limited.