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Fibromuscular dysplasia of renal arteries: Percutaneous revascularization based on hemodynamic assessment with a pressure measurement guidewire
Author(s) -
Mahmud Ehtisham,
Brocato Michele,
Palakodeti Vachaspathi,
Tsimikas Sotirios
Publication year - 2006
Publication title -
catheterization and cardiovascular interventions
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.988
H-Index - 116
eISSN - 1522-726X
pISSN - 1522-1946
DOI - 10.1002/ccd.20621
Subject(s) - medicine , fibromuscular dysplasia , percutaneous , renal artery , cardiology , renal artery stenosis , radiology , angiography , renal artery obstruction , angioplasty , revascularization , renovascular hypertension , stenosis , hemodynamics , blood pressure , kidney , myocardial infarction
Fibromuscular dysplasia (FMD) leading to renal artery stenosis and hypertension is one of the most common treatable causes of secondary hypertension. However, frequently it can be difficult to judge the anatomical severity of a stenotic lesion with various noninvasive and invasive imaging modalities. We present two patients with poorly controlled hypertension and FMD affecting the renal arteries, in whom there were no anatomically significant stenoses by renal magnetic resonance angiography or selective renal artery angiography. Utilizing a 0.014″ high fidelity micromanometer tipped PressureWire XT (Radi, Reading, MA), to measure intravascular pressure gradients throughout the diseased renal arteries, we identified physiologically significant stenoses, and successfully treated both patients with percutaneous transluminal angioplasty. © 2006 Wiley‐Liss, Inc.