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

The role of routine anticogulation in acute myocardial infarction continues to be a source of controversy. There is currently strong evidence to suggest that conventional anticoagulation will prevent the formation of most deep vein thrombi and subsequent pulmonary embolization. Anticoagulant agents also appear to reduce the incidence of emboli from cardiac mural thrombi to peripheral arteries. Patients without a predisposition to bleeding are unlikely to have hemorrhagic complications in the hospital after usual doses of anticoagulant drugs. In patients with severe hypertension, prior gastrointestinal bleeding, carcinoma or advanced age, small dose heparin therapy appears to reduce the incidence of venous thrombosis and probably of pulmonary emboli as well. Its value in preventing peripheral arterial embolization has not been defined. Anticoagulation with standard "large" doses is an effective means of preventing the risks of pulmonary and peripheral emboli during the in-patient phase of acute myocardial infarction. Small dose heparin therapy provides an excellent alternative to conventional anticoagulation when there is more than a negligible risk of hemorrhage. There is little evidence at this time to support the use of long-term anticoagulation beyond the acute phase of myocardial infarction.
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PMID:Anticoagulation in myocardial infarction: modern approach to an old problem. 37 10

Percutaneous transcatheter arterial embolization was performed in a case of severe haemophilia A to control haemorrhage secondary to renal trauma. The treatment proved to be life-saving. Eighteen months follow-up revealed no evidence of hypertension, renal failure or infection.
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PMID:Transcatheter embolization in a haemophiliac with post-traumatic renal haemorrhage. Report of a case. 52 2

Percutaneous transcatheter arterial embolization was used to manage renal hemorrhage secondary to an angiomyolipoma in a solitary kidney. Angiography 3 months after the embolization showed a marked decrease in the mass and vascularity. There was no evidence of hypertension or renal failure following embolization.
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PMID:Management of hemorrhage secondary to renal angiomyolipoma with selective arterial embolization. 83 Sep 60

Hemorrhage from artificially produced renal lacerations was controlled by selective arterial embolization with either plain or Amicar-mixed autogenous blood clot in ten dogs. The laceration sites healed as renal scars. Despite the presence of scattered, small renal infarcts caused by the embolization, hypertension did not develop in any dog during the two-month follow-up. No long-term differences could be detected between kidneys embolized with plain or modified clot. Although it is recognized that dogs have a more active fibrinolytic system than humans, the results of this study suggest that selective arterial embolization is a feasible method for controlling renal hemorrhage.
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PMID:Control of experimental traumatic renal hemorrhage by embolization with autogenous blood clot. 116 74

An attempt was made to control renal hemorrhage by selective embolization of the renal artery in 7 patients. In 2 patients the bleeding site was single, but in 2 others, several sites of arterial extravasation were present. Two patients had arteriovenous fistulas, and 1 had an unsalvageable, macerated kidney. Six of the 7 patients (86 per cent) were treated successfully. Nephrectomy was avoided in 5. No patient developed hypertension during the follow-up of 4 months to 2 years. Our results in these patients indicate that selective arterial embolization should have an important place in the management of patients with renal trauma.
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PMID:Control of renal hemorrhage by selective arterial embolization. 120 Feb 27

Selective intrarenal arterial embolization was used to treat three children with documented renovascular hypertension. Embolization resulted in complete cure (ie, elimination of all antihypertensive medicines) in all three patients and caused only minimal loss of renal parenchyma. Renal vein renin sampling, including sampling after furosemide administration, correlated well with the location of identified vascular lesions and helped direct selective angiography when lesions were not found initially. Intrarenal arterial embolization is a safe, effective alternative to surgical resection in the treatment of renovascular hypertension in children who have identifiable intrarenal arterial lesions not amenable to balloon angioplasty.
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PMID:Segmental renal artery embolization for treatment of pediatric renovascular hypertension. 154 Jul 11

We report our experience of 155 transcatheter arterial embolization (TAE) procedures performed over a period spanning 12 months. The changes relative to the therapeutic approach in renal tumors are discussed. Palliative TAE has increased in comparison to presurgical TAE and the range of possibilities in benign renal pathological conditions has been extended (trauma, hemorrhage, hypertension, etc.). The morbidity ascribable to this technique continues to be low. New embolization materials (ethanol, fine particles, etc.) that are more effective and produce less side effects have become available. To date, TAE continues to be a highly effective therapeutic modality with specific indications and scant morbidity.
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PMID:[Current status of transcatheter arterial embolization in urology]. 172 81

Angiomyolipoma is an uncommon benign tumor of the kidney. The tumor is composed of fat, smooth muscle, and blood vessels. The same pathological entity can appear in two clinically different forms, with or without tuberous sclerosis. We present two cases of renal angiomyolipomas with unusual manifestations. One was associated with tuberous sclerosis and both had the presentation of acute abdomen. Case one presented with epilepsy, angiofibroma, subungual fibroma, periventricular calcification, and bilateral renal angiomyolipomas. Tuberous sclerosis is characterized by these findings. Both cases had spontaneous hemorrhage with hypovolemic shock. Massive hemorrhage resulting in shock is uncommon and the incidence has been estimated to be about 10 per cent. In fact, many angiomyolipomas are clinically occult. The size of the tumor correlates well with the presence or absence of symptoms which include microhematuria, flank pain, hypertension and urinary tract infection. Abdominal CT is the preferred modality for diagnosis of angiomyolipoma. The most important finding is the presence of an intrarenal tumor with fat component which is recognized as a relative low density on CT. Our patients were hospitalized under the impression of angiomyolipoma after the CT study. In addition, the CT defined either the size of the tumor or the extension of the hemorrhage. Although many believe that renal angiography is not sufficient by itself to establish the diagnosis of angiomyolipoma, occasionally it is mandatory in the management of the tumor. The management is decided by two factors, the size of tumor and the clinical presentation. The attitude of management should include conservative treatment with regular follow-up, selective arterial embolization, enucleation, and partial or total nephrectomy.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Unusual presentations of angiomyolipoma]. 179 71

Renal tissue was obtained from 36 patients with renal cell carcinoma, some of whom received renal arterial embolization. The removed specimens was examined histopathologically and the concentration of some vasoactive substances in these patients was measured. Nephrectomy alone produced no discernible changes in blood pressure, vasoactive substances determined or histopathological findings of the kidney. Renal arterial embolization raised the blood pressure in association with the elevation of plasma renin activity (PRA) and urinary prostaglandin (PG) E2 excretion. A linear relationship was found to exist between PRA and mean blood pressure (r = 0.70, p less than 0.001). Hyperplasia of the juxtaglomerular (JG) apparatus, and high granularity of sudan black B granules in renomedullary interstitial cells were confirmed in removed kidneys of patients who had received embolization alone. Subsequently high renin production would be anticipated to influence overproduction of renal PG E2 in acute ischemic kidney in patients with renal cell carcinoma, and hypertension following renal arterial embolization appears to be caused by the hyperplasia of the JG apparatus.
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PMID:Hyperplasia of juxtaglomerular cells and renomedullary interstitial cells after renal arterial embolization in patients with renal cell carcinoma. 306 3

In a patient with idiopatic massive renal bleeding in which dominant abnormal findings could not be identified even by various diagnostic imaging methods, we selectively infused absolute ethanol and a stainless steel coil into one of the renal arteries to stop bleeding. CT two weeks after arterial embolization revealed the infarcted area in the lower pole of kidney. There was no evidence of hypertension or renal failure secondary to artificial renal infarction.
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PMID:Interventional angiographic partial nephrectomy for idiopathic massive renal bleeding. 321 15


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