Renovascular disease impacts blood flow into the kidneys, resulting in kidney damage, failure, and high blood pressure.
These conditions include renal artery stenosis, renal artery thrombosis, renal artery aneurysm, and atheroembolic renal disease.
Many controllable lifestyle choices and uncontrollable factors such as genetics and aging can put a patient at risk for renovascular disease.
Each type of renovascular disease has its own set of symptoms, depending on how severe and where the narrowing or blockage is located.
Renal Artery Stenosis is the narrowing or blockage of an artery leading to the kidneys. Such a narrowing in the renal artery can result in uncontrolled blood pressure and kidney failure. Symptoms of renal artery stenosis include:
Renal Artery Aneurysm is a bulging sac that forms due to weakening of the wall of the artery to the kidney. In most cases, these aneurysms are small and incidental findings during other tests. Usually there are no symptoms. However, very rarely, there may be:
Atheroembolic Renal Disease occurs when a piece of plaque from a larger artery travels and blocks small renal arteries. Symptoms can include
Here at our practice, our doctors and vascular technicians specialize in performing and examining multiple diagnostic tests to assess our patients circulation.
Abdominal Ultrasound: This is a noninvasive imaging study performed at our office that uses soundwaves to visualize artery narrowing. This is a very commonly performed test which only takes about 15 minutes to complete.
Computed Tomography Angiogram (CTA): This is a minimally invasive imaging technique completed at an outside facility. This involves IV contrast into your blood vessels and CT scanning to accurately evaluate the extent of your stenosis. Compared to MRAs, CTs are preferred for optimal visualization.
Renal Angiogram: This is a minimally invasive procedure performed at our outpatient based lab. The procedure begins with a small puncture made to access the femoral arteries and guided to the artery of interest. Contrast dye is delivered through this tube. Throughout the procedure, the vascular surgeon uses real-time x-ray images and contrast dye injections to visualize the circulation and any blockage in the artery of interest.
Nonsurgical Treatment
For patients with mild blockages without notable symptoms, our physicians and team at BEVSA work with you to develop a treatment plan to prevent the progression of your disease.
Risk Factor Modification: Tobacco use damages the arterial walls which makes it easier for plaque to build up and cause complications such as reduced kidney function.. If you need help quitting smoking, our physicians will help you obtain information on medication, nicotine replacement products, and programs to make it easier
Diet and Activity: It is important to maintain a diet low in saturated fat, cholesterol, and sodium. Foods with these components can elevate cholesterol levels making it more likely for plaque to build up in the artery and cause narrowing. Our physicians will work with you to develop a customized, feasible, exercise plan and dieting.
Medication Management: Risk factors include elevated cholesterol/fat levels and type 2 diabetes. Statins have been shown to manage cholesterol/fat levels, stabilize plaque, and reduce the risk of plaque buildup. In addition patients with type 2 diabetes should engage in good glycemic control and work with their physician to achieve low levels of A1C. Our physicians will work with you to ensure you are on the proper medication regimen to lessen your risk of developing additional renal artery atherosclerosis.
Surgical Treatment
Minimally Invasive Procedure: This is an angiogram procedure performed at our office that only involves a small incision in the groin. A catheter (long, flexible tube) is then inserted in the arm to inject contrast dye into the arteries of the abdomen. The dye and real time x-ray images are used to identify where blockages in the leg arteries are occurring. After the blockage is identified, the vascular surgeon may use angioplasty or stenting to improve the circulation. Angioplasty is when a small balloon is inflated inside of the vessel to widen it and then removed. A stent, which is a hollow, metal scaffold, is placed permanently inside the artery to hold it open. There are also drug eluting stents which release drugs that fight any further plaque buildup in the stent itself. At BEVSA, our practice is one of the leaders in the region at safely and effectively performing these procedures outside of the hospital at our specialized outpatient procedure facility or at Gates Vascular Institute. The procedure takes about 1-2 hours and only requires local sedation. Patients are discharged home the same day as the procedure.