St Helier Hospital Carshalton

St Helier, United Kingdom

St Helier Hospital Carshalton

St Helier, United Kingdom
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Somalanka S.,St Helier Hospital Carshalton | Harris F.E.,St Helier Hospital Carshalton | Chemla E.,St Georges Healthcare NHS Trust | Suckling R.J.,St Helier Hospital Carshalton | Swift P.A.,St Helier Hospital Carshalton
BMJ Case Reports | Year: 2017

Renal Artery Stenosis (RAS) is an important cause of treatment-resistant hypertension. Uncontrolled hypertension with RAS can cause progressive chronic kidney disease (CKD) leading to end-stage kidney disease. Therapeutic revascularisation can be helpful in appropriate circumstances where pharmaceutical intervention has failed and significant renovascular disease contributes to resistant hypertension. We present an interesting case of a Caucasian male with peripheral vasculopathy, abdominal aortic aneurysm (AAA), single functioning kidney and ostial RAS caused by stent struts from an endovascular AAA stent graft. He had escalating medications requirement, with repeated failed attempts at percutaneous radiological intervention that led to an episode of contrast-induced acute kidney injury (AKI), before undergoing successful surgical revascularisation by a splenic artery transposition graft to the left renal artery that was performed to improve kidney function and the blood pressure. This report highlights the challenges faced with regard to the management of severe hypertension and progressive CKD. © BMJ Publishing Group Ltd (unless otherwise stated in the text of the article) 2017. All rights reserved.

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