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Renal Endovascular Stenting of a Non-atherosclerotic Renal Artery Stenosis secondary to Takayasu Arteritis: A Case Report

Elrey Inocian

Background: Takayasu arteritis (TA) is a rare inflammatory and stenotic diseases of medium- and large-sized arteries with an incidence rate of 1.2-2.6 per million. It has a strong predilection to the aortic arch and its branches but may cause renal artery stenosis (RAS) in few cases. The symptoms of TA are often alleviated with glucocorticoids. However, in case of impending renal insufficiency, angioplasty or stenting is usually indicated. Stenting has been well-described in atherosclerotic RAS but not in non-atherosclerotic RAS secondary to Takayasu arteritis. Hence, it is imperative to report this uncommonly performed procedure in a rare case of non-atherosclerotic RAS secondary to Takayasu arteritis and its outcomes.

 

Case Presentation: A 38-year old, female, Filipino Descent, had an incidental finding of small left kidney on ultrasound. Blood pressure and pulse discrepancies were noted on both extremities. Renal artery duplex scan showed a totally occluded left renal artery and hemodynamically significant right renal artery stenosis. Invasive renal angiography and aortogram confirmed these findings, which also revealed stenosis of the subclavian arteries and the celiac artery and its branches, consistent with Type V Takayasu

 

 

 

arteritis. Patient underwent stenting of the right renal artery, which resulted to a remarkable improvement in the blood pressure and right renal artery velocity. Six months after the procedure, invasive angiography was performed, which demonstrated the still widely patent right renal artery stent.

 

Conclusion: The use of renal endovascular stenting is an effective treatment option with good clinical outcomes in non-atherosclerotic renal artery stenosis secondary to Takayasu arteritis.

 

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            Biography

 

          1. Dr. Elrey P. Inocian is a second year Internal       Medicine Resident Physician in Perpetual Succour  Hospital in Cebu City, Philippines. He graduated Cumlaude during in his Medical School.

 

Dr. Brett Batoctoy is a Cardiologist in Perpetual Succour Hospital.