Renal Angioplasty

Renal artery stenting is performed during an angioplasty operation, which entails placing a tiny catheter into a damaged renal artery. The balloon on the end of an angioplasty catheter is used to inflate or enlarge the constricted region.

Renal artery angioplasty is a technique that widens the aperture of the kidney's blood vessels. The most common cause of arterial occlusion is narrowing of the renal artery (renal artery stenosis). Atherosclerosis or fibrous disease of the arteries is the most common cause of renal artery stenosis.

Disease Overview:

Renal artery stenosis

Renal artery stenosis is a narrowing of one or more of the arteries that provide blood to the kidneys (renal arteries). The narrowing of arteries limits the regular flow of oxygen-rich blood to your kidneys. To filter waste materials and eliminate extra fluids, your kidneys require enough blood flow. Reduced blood supply to the kidneys can cause damage to the tissue and raise blood pressure throughout the body.

Signs and Symptoms

Renal artery stenosis frequently has no symptoms or indicators until it is advanced. It's possible that the issue will be discovered by chance when checking for anything else. If you experience any of the following symptoms, your doctor may notice a problem:

• High blood pressure that appears out of nowhere or develops without warning
• High blood pressure that develops before the age of 30 or after the age of 50 is referred to as pre-hypertension.
• Additional signs and symptoms of renal artery stenosis include:
• High blood pressure that is difficult to manage
• A whooshing sound heard by your doctor with a stethoscope placed over your kidneys as blood rushes through a constricted artery (bruit).
• Protein levels in the urine that are abnormally high or other symptoms of impaired kidney function
• Kidney function deteriorates as a result of high blood pressure therapy
• Swelling of the body's tissues due to fluid excess
• Heart failure that is resistant to treatment

Disease Causes

Renal artery stenosis is caused by two primary factors:

Inflammation of the kidney (renal) arteries. Plaque (fats, cholesterol, and other chemicals) can build up in and on the walls of your renal arteries (atherosclerosis). These deposits can solidify, reducing blood flow, causing kidney scarring, and eventually narrowing the artery as they become bigger. The most prevalent cause of renal artery stenosis is atherosclerosis, which can affect any part of the body.

Fibromuscular dysplasia is a kind of fibromuscular dysplasia. The muscle in the arterial wall develops improperly in fibromuscular dysplasia, which usually begins in childhood. The renal artery can contain thin parts that alternate with broader sections, giving photographs of the artery a bead-like appearance.

The renal artery can constrict to the point that the kidneys don't get enough blood, resulting in high blood pressure at a young age. One or both kidneys may be affected. Experts aren't sure what causes fibromuscular dysplasia, although it's more frequent in women and might even be present from birth (congenital).

Kidney artery narrowing and fibromuscular dysplasia might create issues in other arteries in your body as well as your kidney arteries.

Renal artery stenosis can also be caused by other illnesses such as blood vessel inflammation or a tumour that forms in your belly and pushes on your kidneys' arteries.

Diagnosis

Your doctor may start with the following tests to diagnose renal artery stenosis:

A physical exam in which your doctor listens over the kidney regions using a stethoscope for noises that might indicate a constricted artery to your kidney.

A look back at your medical history

Kidney function is assessed using blood and urine testing.

Tests of blood and urine to determine the amounts of hormones that control blood pressure.

The following imaging studies are routinely used to identify renal artery stenosis:

Ultrasound with Doppler. Your doctor can inspect the arteries and kidneys and examine their function using high-frequency sound waves. This technique also aids your doctor in locating and assessing blood artery obstructions.

CT scan is a type of x-ray. An X-ray equipment connected to a computer provides a detailed picture showing cross-sectional views of the renal arteries during a CT scan. A dye injection may be given to indicate blood flow.

Magnetic resonance angiography (MRI angiography) is a type of (MRA). MRA creates comprehensive 3D pictures of the renal arteries and kidneys using radio waves and high magnetic fields. During imaging, a dye is injected into the arteries to define blood vessels.

Renal arteriography is a procedure that examines the blood vessels in the kidneys. This sort of X-ray aids your doctor in locating a blockage in the renal arteries and, in certain cases, opening the restricted section using a balloon and/or stent.

Disease Treatment

Renal artery stenosis can be treated with a combination of lifestyle modifications, medication, and a procedure to restore blood flow to the kidneys. A mix of therapies is sometimes the best option. You may not require any therapy at all, depending on your general health and symptoms.

Changes in your way of life

A healthy lifestyle ? reducing sodium, eating nutritious foods, and getting regular physical activity ? can help lower your blood pressure if it is moderately or severely raised.

Medication

High blood pressure, especially when caused primarily by renal artery stenosis, is frequently managed satisfactorily with medicines. It may take some time and patience to find the proper drug or combination of medications.

Some of the drugs often used to treat high blood pressure caused by renal artery stenosis are listed below.

The following procedures may be used to treat renal artery stenosis:

Angioplasty and stenting of the kidneys. Doctors expand the restricted renal artery and put a device (stent) into your blood vessel that keeps the vessel walls open and allows for greater blood flow in this surgery.

Renal artery bypass surgery is a procedure that involves bypassing the arteries in the kidneys During a bypass operation, surgeons graft a new blood vessel onto the renal artery to provide a fresh blood supply to your kidneys. Connecting the renal artery to a vascular from somewhere else, such as the liver or spleen, is sometimes necessary. When angioplasty fails or other surgical procedures are required, these surgeries are most commonly performed.