Access the full text.
Sign up today, get DeepDyve free for 14 days.
Loading next page...
/lp/oxford-university-press/entrapped-renal-artery-in-the-left-crux-of-diaphragm-a-rare-cause-of-obn80PQoz7
References (3)
-
C. Ozmen, T. Hazırolan, M. Canyigit, B. Peynircioğlu, B. Çil (2006)
An unusual reason for renovascular hypertension: entrapment of an accessory renal artery by the diaphragmatic crus.Journal of vascular and interventional radiology : JVIR, 17 10
-
F. Thony, J. Baguet, M. Rodière, C. Sessa, B. Janbon, G. Ferretti (2005)
Renal artery entrapment by the diaphragmatic crusEuropean Radiology, 15
-
A. Mirza, M. Kendrick, T. Bower, R. DeMartino (2019)
Renovascular hypertension secondary to renal artery compression by diaphragmatic cruraJournal of Vascular Surgery Cases and Innovative Techniques, 6
- Publisher
- Oxford University Press
- Copyright
- © The Author(s) 2020. Published by Oxford University Press on behalf of the European Society of Cardiology.
- eISSN
- 2514-2119
- DOI
- 10.1093/ehjcr/ytaa022
- Publisher site
- See Article on Publisher Site
Abstract
Downloaded from https://academic.oup.com/ehjcr/article-abstract/4/2/1/5739980 by guest on 28 April 2020 IMAGES IN CARDIOLOGY European Heart Journal - Case Reports (2020) 4, 1–2 doi:10.1093/ehjcr/ytaa022 Other Entrapped renal artery in the left crux of diaphragm: a rare cause of malignant hypertension 1 2 Anshul Kumar Jain * and Awnish Kumar 1 2 Department of Cardiology, Sri Aggarsain International Hospital, Sector 22, Rohini, New Delhi, Delhi 110086, India; and Department of Radiodiagnosis, Sri Aggarsain International Hospital, Sector 22, Rohini, New Delhi, Delhi 110086, India Received 18 November 2019; first decision 19 December 2019; accepted 21 January 2020 A 36-year-old obese female presented with acute onset headache, . Grade 1 diastolic dysfunction. Computed tomography (CT) scan vomiting, and weakness of right side of the body. Her blood pressure . head revealed intracranial haemorrhage (left basal ganglia bleed) was noted to be 220/140 mmHg. On physical examination, she had (Supplementary material online, Figure S1) She was managed with right-sided hemiparesis. Fundoscopy showed Grade 1 hypertensive intravenous labetolol, furosemide, and oral amlodipine. Gradually, retinopathy. No renal bruit was audible. Electrocardiogram revealed the intravenous drugs were discontinued and oral medications left ventricular hypertrophy (LVH). On echocardiography, she had including amlodipine, telmisartan, moxonidine, eplerenone, and fur- concentric LVH, with normal left ventricular systolic function and osemide optimized. Serum biochemistry including renal functions Figure 2 Computed tomography curved reformat showing com- Figure 1 Computed tomography angiography (coronal section). pression of the left renal artery by the left diaphragmatic crux as Asterisk indicates discrete luminal stenosis caused by the left renal compared to the normal course and calibre of the right renal artery. artery coursing through the crux of diaphragm. Ao, thoracic aorta. Ao, aorta; LRA, left renal artery; RRA, right renal artery. * Corresponding author. Tel: þ91 98 100 20393, Email: jain_anshul_dr@hotmail.com Handling Editor: Sameh Shaheen Peer-reviewers: Panagiotis Xaplanteris and Subhi Akleh V The Author(s) 2020. Published by Oxford University Press on behalf of the European Society of Cardiology. This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact journals.permissions@oup.com Downloaded from https://academic.oup.com/ehjcr/article-abstract/4/2/1/5739980 by guest on 28 April 2020 2 A.K. Jain and A. Kumar was unremarkable. Ultrasound abdomen revealed normal kidney . controlled on oral medications. She has refused for any inter- size. Renal Doppler was suggestive of pulsus parvus et tardus . ventional procedure. (Supplementary material online, Figure S2) in the intra-renal branch of . Supplementary material the left renal artery. A CT aortogram revealed a discrete narrowing . of the left renal artery due to entrapment by the left crux of dia- . Supplementary material is available at European Heart Journal - Case phragm. There was no evidence of atherosclerosis or calcification of . . Reports online. the renal artery (Figures 1 and 2; Supplementary material online, Figure S3). Consent: The author/s confirm that written consent for submission The renal artery entrapment causing malignant hypertension and publication of this case report including image(s) and associated is very rare. A renal artery with high origin, coursing parallel text has been obtained from the patient in line with COPE guidance. to the aorta in its proximal part, discrete stenosis and adjacent Conflict of interest: none declared. prominent crux should raise a strong suspicion of this diagnosis. Occasionally, respirophasic compression of renal artery may be 2 References demonstrable on CT imaging. The treatment options include . 1. Ozmen CA, Hazirolan T, Canyigit M, Peynircioglu B, Cil BE. An unusual reason for medical therapy, stents or surgical (laparoscopic) decompres- renovascular hypertension: entrapment of an accessory renal artery by the dia- sion of the artery or reconstruction. The laparoscopic decom- phragmatic crus. J Vasc Interv Radiol 2006;17:1713–1714. 2. Mirza AK, Kendrick ML, Bower TC, DeMartino RR. Renovascular hypertension sec- pression is considered to be the gold standard of treatment ondary to renal artery compression by diaphragmatic crura. J Vasc Surg 2019;70:e72. because of the high risk of stent deformation or fracture in 3. Thony F, Baguet JP, Rodiere M, Sessa C, Janbon B, Ferretti G. Renal artery entrap- 2,3 the entrapped renal artery. In our case, the patient is well ment by the diaphragmatic crus. Eur Radiol 2005;15:1841–1849.
Journal
European Heart Journal - Case Reports – Oxford University Press
Published: Jun 1, 2020