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Query: UMLS:C0020538 (hypertension)
 170,190 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Two cases, in siblings, of renovascular hypertension caused by fibromuscular dysplasia (FMD) of the renal artery associated with cerebral aneurysms are reported. Both of the cases were found to have cerebral aneurysm, as well as multiple stenotic or occluded lesions in arteries such as renal, mesenteric, celiac, and internal carotid arteries. One case died of subarachnoid hemorrhage and the other case was successfully operated on for the aneurysm. This report suggests that FMD should be considered to be a systemic angiopathy including the cerebral artery, as well as the renal artery. Thus, cerebral angiography is recommended to detect the association with cerebral aneurysm, at least, in cases with multiple lesions of FMD. Occurrence of FMD in siblings also indicates that a genetic factor might be involved in the pathogenesis of FMD.
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PMID:Clinical significance of cerebral aneurysm in renovascular hypertension due to fibromuscular dysplasia: two cases in siblings. 271 43

In 516 patients who had endarterectomies for unilateral severe carotid stenoses, arteriography demonstrated no contralateral severe stenoses or occlusions. Pre and postoperative ocular pneumoplethysmography (OPG-Gee) measured simultaneous bilateral ophthalmic systolic pressures (OSP). Immediately after each OPG test a brachial systolic pressure (BSP) was measured with a stethoscope, cuff and manometer. Bilateral ophthalmobrachial systolic pressure (OBSP) indices were calculated from the three pressures measured with the combined testing. Analysis of these OBSP data indicates that the severe stenoses were relatively well compensated in 314 of the 516 patients (61%) whereas there was limited collateral compensation in the remaining 202 patients (39%). The data also suggest that the latter group incurs a greater element of compensatory central hypertension, which is reversed by carotid endarterectomy.
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PMID:Collateral compensation of severe carotid stenosis. 276 52

We describe the surgical management of six patients with occlusive disease of the visceral arteries caused by Takayasu's arteritis. All patients suffered from renovascular hypertension and, in addition, three of the patients also had symptoms of mesenteric angina. Surgical repair is recommended in the "burn-out" phase of the disease when further progression of the disease is unlikely. Revascularization of the kidneys was by autotransplantation to the iliac vessels. Mesenteric or celiac artery inflow was provided by an extra-anatomic vein bypass graft from the iliac artery. In all cases distal disease-free vessels were available for reconstructive surgery.
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PMID:Surgical repair of visceral artery occlusions in Takayasu's disease. 287 40

A case of polyarteritis nodosa (PAN) in a 54 year-old man is presented. The clinical picture showed a 6-month history of mixed sensorimotor distal symmetrical polyneuropathy in all limbs together with anorexia, weight loss, fatigue, arthralgia, myalgia, mild fever and hypertension. The laboratory studies showed leucocytosis, elevated ESR, positive HBsAg and presence of cryoglobulins. Selective renal, celiac and mesenteric angiography was performed by femoral approach and has showed innumerable aneurysms most of them in hepatic and renal circulation. After about two weeks death has occurred. A brief discussion is done on clinical aspects of PAN pointing out the importance of HBsAg determination on etiopathogenesis and angiographic study on diagnosis.
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PMID:[Polyarteritis nodosa: report of a case with angiographic study]. 287 24

Because previous data have suggested a dependence of ganglionic atrial natriuretic factor (ANF) content on preganglionic cholinergic input, we investigated the possibility that the increased neural activity observed in spontaneously hypertensive rats (SHR) may be reflected by ganglionic immunoreactive ANF levels. Four-week-old normotensive SHR had celiac ganglionic immunoreactive ANF values comparable to those of Wistar-Kyoto rats (WKY). When they became hypertensive, however, at 12 weeks of age, the SHR manifested higher immunoreactive ANF levels in celiac ganglia than the WKY group (25.3 +/- 2.6 vs 14.5 +/- 1.7 pg/ganglion; p less than 0.01), but there were no differences in levels in the superior cervical and nodose ganglia. The values in celiac ganglia were quadrupled on the average in hypertensive Dahl salt-sensitive rats under the influence of an 8% salt intake for 5 weeks, but no difference was noted in any of these ganglia between this group and their salt-resistant partners. The celiac and superior cervical ganglionic immunoreactive ANF content in normotensive Sprague-Dawley rats was higher with high salt than with normal salt intake. Hypertensive rats treated with deoxycorticosterone acetate (DOCA)-salt and sham-treated controls showed immunoreactive ANF concentrations in celiac ganglia similar to those detected in Dahl rats but, again, no differences were found between groups. Thus, hypertensive SHR, compared to WKY, have higher celiac ganglionic immunoreactive ANF levels, unlike Dahl salt-sensitive and DOCA-salt animals relative to their respective controls. This increase is unique to SHR (although all three models have elevated plasma immunoreactive ANF when they are hypertensive) and to the celiac ganglia.(ABSTRACT TRUNCATED AT 250 WORDS)
Hypertension 1988 Feb
PMID:Ganglionic immunoreactive atrial natriuretic factor in rat experimental hypertension. 296 3

Coarctation of the abdominal aorta constitutes a rare group of vascular abnormalities, including segmental stenoses and extended hypoplasia. Hypertension is the usual solitary clinical finding and contrasts with the diversity of anatomic lesions and surgical techniques used for treatment. It is often difficult to determine whether the lesion is congenital or due to Takayasu's aortitis. Three cases of hypoplasia in adolescents are reported. Treatment consisted of an aortoaortic bypass in all cases. Vein angioplasty of the renal arteries was performed concomitantly in one case of inter- and infrarenal hypoplasia associated with stenosis of the two renal arteries. In one of the two cases of suprarenal hypoplasia, the celiac axis was reimplanted after excision of an associated aneurysm. In all three cases, blood pressure returned to normal values without medical treatment.
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PMID:Coarctation of the abdominal aorta. 319 48

A successful surgical case of ruptured thoracoabdominal aortic aneurysm of Crawford type III was reported. The patient was a 40-year-old male suffering from cystic kidney, hypertension and dissecting aortic aneurysm. The operative procedure was implantation of a large Dacron graft between the ascending aorta and the common iliac arteries, with branches of small Dacron grafts anastomosed to the left common carotid, left subclavian, celiac, superior mesenteric and renal arteries, and exclusion of the aorta.
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PMID:[Extra-anatomic bypass operation of ruptured thoracoabdominal aortic aneurysm]. 320 58

Between 1975 and 1985, 43 patients underwent simultaneous aortic and renal artery reconstruction. Twenty-two patients had infrarenal abdominal aortic aneurysms and 21 had aortoiliac occlusive disease. In addition, 40 patients had severe lesions of one or both renal arteries and three patients had a lesion in an accessory renal artery. Hypertension was present in 29 patients, 15 of whom had impaired renal function. Four patients had chronic renal insufficiency without hypertension. Ten patients underwent prophylactic renal artery reconstruction. Infrarenal aortic repair was carried out simultaneously with thromboendarterectomy of one or both renal arteries, or reimplantation of a renal artery into the aorta, in two cases with contralateral nephrectomy. In one patient, the celiac and superior mesenteric arteries were also bypassed. Three patients (7%) died in the immediate postoperative period, two of these from myocardial infarction. Long-term survival was studied in 37 patients. Sixty-seven percent of patients with preoperative hypertension and less than 50% of those with preoperative renal insufficiency had good results.
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PMID:Atherosclerotic lesions of the aorta and renal arteries: results of simultaneous surgical treatment. 322 60

Of 15 patients having revascularization of the right renal artery with the use of the hepatic circulation from May 1984 through March 1987 at the Massachusetts General Hospital, eight patients had this accomplished with end-to-end anastomosis of the gastroduodenal artery and right renal artery. Operative indications were acute azotemic renal failure (three patients), poorly controlled renovascular hypertension (four patients), and staged repair of bilateral renal artery disease (one patient). All revascularizations were successful in restoring renal function or rendering hypertension manageable and were assessed by means of renal flow scans, celiac angiography, or return of function in those patients with a solitary, functioning kidney. All patients survived the operation with one late death caused by myocardial infarction after abdominal aortic aneurysm repair. The gastroduodenal artery may be used as the source for arterial inflow in revascularization of the right renal artery by end-to-end anastomosis in approximately 50% of instances, conferring the advantage of the use of only one anastomosis and obviating the long-term possibility of vein graft failure.
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PMID:Use of the gastroduodenal artery in right renal artery revascularization. 339 73

In a 38-year-old woman, arterial hypertension was diagnosed a few weeks before her death. She died unexpectedly before a diagnostic clarification of the cause was possible. Autopsy revealed an arterial fibromuscular dysplasia with manifestation in both common iliac arteries, both renal arteries, the celiac trunk and the splenic artery. Both renal arteries displayed stenotic dissecant aneurysms which were the cause of the arterial hypertension. As a rare and lethal complication of fibromuscular dysplasia, a ruptured saccular aneurysm was found in the splenic artery. Histologically, the vascular alterations were a combination of medical fibromuscular dysplasia (type II) and periarterial or adventitial fibroplasia (type III). On the basis of the immunohistochemical detection of abundant lysozyme-positive cells, the periarterial fibroplasia appears to be a secondary chronic granulating and cicatricial reaction and not a separate form of fibromuscular dysplasia.
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PMID:[Arterial fibromuscular dysplasia as an unexpected cause of death in adults]. 367 85


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