DOI QR코드

DOI QR Code

Successful Percutaneous Renal Artery Angioplasty and Stenting for Acute Oliguric Renal Failure in a Solitary Functioning Kidney Caused by Takayasu's Arteritis

  • Yoo, Suk-Hee (Division of Cardiology, Department of Internal Medicine, Chungbuk National University School of Medicine) ;
  • Kim, Gi-Hyun (Division of Cardiology, Department of Internal Medicine, Chungbuk National University School of Medicine) ;
  • Lee, Won-Ick (Division of Cardiology, Department of Internal Medicine, Chungbuk National University School of Medicine) ;
  • Kwon, Soon-Kil (Division of Cardiology, Department of Internal Medicine, Chungbuk National University School of Medicine) ;
  • Lee, Sang-Yeub (Division of Cardiology, Department of Internal Medicine, Chungbuk National University School of Medicine) ;
  • Bae, Jang-Whan (Division of Cardiology, Department of Internal Medicine, Chungbuk National University School of Medicine) ;
  • Hwang, Kyung-Kuk (Division of Cardiology, Department of Internal Medicine, Chungbuk National University School of Medicine) ;
  • Kim, Dong-Woon (Division of Cardiology, Department of Internal Medicine, Chungbuk National University School of Medicine) ;
  • Cho, Myeong-Chan (Division of Cardiology, Department of Internal Medicine, Chungbuk National University School of Medicine)
  • Received : 2010.01.05
  • Accepted : 2010.01.27
  • Published : 2010.08.30

Abstract

Takayasu's arteritis (TA) is a nonspecific, chronic and stenotic panarteritis which usually involves the aorta and its major branches. Corticosteroid and immunosuppressants are recommended to manage the acute inflammatory phase, but their long term benefits are uncertain. Blood pressure (BP) control during the chronic phase of TA is essential to preserve renal function, which is associated with the patient's long-term prognosis and survival. Revascularization in organ damaging arterial stenosis with percutaneous angioplasty (PTA)/stenting or bypass surgery have been accepted as established treatment options in chronic complicated phase of TA. We present a case of a 31-year-old female patient with a two-day history of sudden onset oliguria and generalized edema whose acute oliguric renal failure was successfully reversed following PTA and stenting in a solitary functioning kidney with critical renal artery stenosis (RAS) caused by TA.

Keywords

References

  1. Liang P, Hoffman GS. Advances in the medical and surgical treatment of Takayasu arteritis. Curr Opin Rheumatol 2005;17:16-24. https://doi.org/10.1097/01.bor.0000146607.65808.37
  2. Ishikawa K. Diagnostic approach and proposed criteria for the clinical diagnosis of Takayasu's arteriopathy. J Am Coll Cardiol 1998;12:964-72.
  3. Kim KC, Park JI, Lee J, et al. Clinical characteristics of Takayasu's arteritis. Korean Circ J 2001;31:1106-16. https://doi.org/10.4070/kcj.2001.31.11.1106
  4. Kerr GS, Hallahan CW, Giordano J, et al. Takayasu's arteritis. Ann Intern Med 1994;120:919-29.
  5. Chandy ST, John B, Kamath P, John GT. Exclusive carbon dioxideguided renal artery stenting in a case of Takayasu's arteritis with a solitary functioning kidney. Indian Heart J 2003;55:272-4.
  6. Kelly AM, Dwamena B, Cronin P, Bernstein SJ, Carlos RC. Metaanalysis: effectiveness of drugs for preventing contrast-induced nephropathy. Ann Intern Med 2008;148:284-94. https://doi.org/10.7326/0003-4819-148-4-200802190-00007
  7. Feldman RL, Wargovich TJ, Bittl JA. No-touch technique for reducing aortic wall trauma during renal artery stenting. Catheter Cardiovasc Interv 1999;46:245-8. https://doi.org/10.1002/(SICI)1522-726X(199902)46:2<245::AID-CCD27>3.0.CO;2-V
  8. Lee PT, Chou KJ, Liu CP, et al. Renal protection for coronary angiography in advanced renal failure patients by prophylactic hemodialysis. A randomized controlled trial. J Am Coll Cardiol 2007;50:1015-20. https://doi.org/10.1016/j.jacc.2007.05.033
  9. Bali HK, Jain S, Jain A, Sharma BK. Stent supported angioplasty in Takayasu arteritis. Int J Cardiol 1998;6(Suppl 1):S213-7.
  10. Sharma BK, Jain S, Bali HK, Jain A, Kumari S. A follow-up study of balloon angioplasty and de-novo stenting in Takayasu arteritis. Int J Cardiol 2000;75(Suppl 1):S147-52. https://doi.org/10.1016/S0167-5273(00)00192-3
  11. Tanaka R, Higashi M, Naito H. Angioplasty for non-arteriosclerotic renal artery stenosis: The efficacy of cutting balloon angioplasty versus conventional anigioplasty. Cardiovasc Intervent Radiol 2007;30:601-6. https://doi.org/10.1007/s00270-007-9000-2
  12. Reddan D, Laville M, Garovic VD. Contrast-induced nephropathy and its prevention: What do we really known from evidence-based findings? J Nephrol 2009;22:333-51.
  13. Singer GM, Setaro JF, Curtis JP, Remetz MS. Distal embolic protection during renal artery stenting: impact on hypertensive patients with renal dysfunction. J Clin Hypertens 2008;10:830-6. https://doi.org/10.1111/j.1751-7176.2008.00030.x
  14. Hawkins IF, Cho KJ, Caridi JG. Carbon dioxide in angiography to reduce the risk of contrast-induced nephropathy. Radiol Clin North Am 2009;47:813-25. https://doi.org/10.1016/j.rcl.2009.07.002
  15. Safian RD, Madder RD. Refining the approach to renal artery revascularization. JACC Cardiovasc Interv 2009;2:161-74.