Stenosis is a common name for diseases accompanied by a sharp and steady narrowing of any anatomical cavity of the body. Stenosis of the renal artery is one of the most common types of such pathological changes, as a result of which the cross-section of blood vessels through which arterial blood-saturated arterial blood enters the kidneys decreases. It is a concomitant disease, so recovery or prolonged remission is possible only if the main treatment is started in time.
Types of renal artery stenosis
Because the kidney is a paired organ, stenosis of the arteries can occur in the right or left renal artery. A more complex case is bilateral stenosis. Reduction of the lumen of the vessels can occur both in the mainstream bloodstream and in its peripheral canals. According to the ICD-10( international classification of diseases), it is assigned the code I15.0, which stands for Renovascular hypertension.
Causes of
According to official medical statistics, in seventy percent of cases this disease occurs due to the deposition of atheromatous plaques on the walls of the renal arteries. The remaining thirty occur in congenital or acquired malformations of blood vessel tissue( fibromuscular dysplasia), as well as nephrologic pathologies and trauma( external compression).
Risk factors are: age-related organ changes, smoking, obesity, genetic predisposition and a number of diseases. For example, diabetes mellitus.
Pathogenesis of
As a result of blood supply disorders, oxygen starvation of kidney tissues is observed, which provokes pathological changes in them. They cease to fulfill their basic function of filtering blood from toxins and toxins. In addition, the laws of hydrodynamics are also true of the human body.
Symptoms of
Symptomatic of the course of the disease is very individual. In general, it corresponds to hypertension( hypertension).This is a headache and dizziness, a vision disorder - the flashing of "flies".
There are often pains in the ears, eyeballs. The sleep is disturbed, mood can change( emotional lability), memory can worsen. Patients complain of heart palpitations, weakness, paroxysms of chest pain, irradiating to the left arm.
Diagnosis
The diagnosis of" stenosis of the renal arteries "is based on a comprehensive examination. Such conclusions can lead, for example, asymmetry of arterial pressure on various extremities, recording not only systolic, but also diastolic noise when listening to the zone of location of the renal arteries.
If the patient's condition is dangerously severe, ultrasound( duplex scanning or ultrasound), computer or positron emission tomography, selective or magnetic resonance angiography may be performed.
Treatment of
Perhaps as a drug, backed by a number of therapeutic measures, and surgical. The first is always ancillary, not eliminating the root cause of the disease finally.
Patients prescribed antihypertensive and diuretic drugs, anticoagulants, drugs that reduce the blood levels of cholesterol and triglycerides. Therapeutic measures - smoking cessation, weight loss.
Its most common type is balloon dilatation( stenting), in which a balloon catheter is inserted into the affected vessel, expanding it, and a mesh stent that strengthens the walls. This is an endoscopic, minimally invasive intervention conducted through a puncture in the femoral artery.
Other methods of surgical treatment are shunting the affected area of the artery or removing the sclerotic plaque - endarterectomy - along with part of the internal tissues of the vessel.
The most cardinal type of surgical intervention in this disease is the replacement of the affected area of the artery with an autograft or a synthetic prosthesis.
On video, stenting of the renal artery:
Forecast
The performed operation normalizes blood pressure in 50-60% of patients if the cause of stenosis was atherosclerosis, and in 70-80%, suffering from fibromuscular dysplasia. The result is achieved within six months after the invasive manipulation.
The residual arterial hypertension is stopped by hypotensive drugs. The operated ones are registered with the nephrologist and cardiologist for dispensary observation.