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

Coral reef aorta is a rare condition characterised by extreme calcific growths affecting the juxta and suprarenal aorta. It can cause symptoms due to visceral ischaemia, lower limb hypoperfusion, and distal embolisation. We present a case of a 61-year-old man with unresponsive hypertension, who was found to have an occluded right renal artery, and an extensive coral reef aorta with a marked pressure gradient across the lesion. Renal hypoperfusion secondary to aortic coral reef aorta was thought to be the cause for his hypertension. Endovascular placement of a balloon expandable uncovered stent resolved his hypertension within one month, with no adverse effects noted at subsequent follow-up. Endovascular treatment of coral reef aorta is technically possible and avoids a major vascular procedure.
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PMID:Treatment of symptomatic coral reef aorta with an uncovered stent graft. 2539 87

Coral reef aorta is rare type of atherosclerotic diseases with severe calcification in the visceral part of the aorta. We present a case of coral reef aorta with severe abdominal aortic stenosis in a 67-year-old man. The patient presented with hypertension, claudication, and rapid progression of renal dysfunction over several months. Angiography revealed a severely stenotic suprarenal abdominal aorta resulting in renal ischemia and dysfunction. In addition, his right kidney was completely atrophied. After open surgical repair of the stenotic aorta including renal artery reconstruction, renal function did not improve. There was stenotic anastomosis to the renal artery. After endovascular therapy to the stenotic anastomosis, renal function dramatically improved. Stenotic coral reef aorta may be the cause of kidney dysfunction. In addition, surgical complication of stenotic anastomosis may be successfully treated by endovascular therapy.
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PMID:A Case of Rapid Progressive Kidney Dysfunction with Severely Calcified Stenotic Aorta. 3064 91

Coral reef aorta (CRA) is a rare condition, characterised by rock-hard calcification of the juxta-renal and supra-renal aorta with luminal encroachment causing significant stenosis of the aorta and its branches. It usually presents as resistant hypertension, renal dysfunction, mesenteric ischaemia, limb claudication or embolic manifestations. Although surgical thrombo-endarterectomy along with bypass graft to the affected visceral arteries remains the cornerstone of treatment, it is associated with considerable mortality and morbidity, especially in patients with pre-existing comorbidities. Here we report an elderly female of resistant hypertension, who had successful endovascular aortic stenting using a non-graft self-expanding stent. Her blood pressure dramatically improved following endovascular management. In comparison to the conventional surgical approach, endovascular stenting can be an alternative, less invasive approach in selected CRA patients.
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PMID:Treatment of symptomatic coral reef aorta by a nitinol self-expanding stent. 3107 94

Coral reef aorta (CRA), a rare disease, is characterized by severe calcification of the juxta-renal and suprarenal aorta that grows into the lumen and leads to severe stenosis. A 70-year-old woman with refractory hypertension and lower limb claudication presented with hypertension and congestive heart failure. Treatment with vasodilators and diuresis led to oliguria and exacerbated kidney function, while her congestion remained. Abdominal computerized tomography showed a bulky, irregular localized supra-renal aortic calcification with stenosis. A peripheral artery ultrasound and angiography showed no occlusive lesions in the distal run-off vessels. Based on her medical history and the unique aspects of the localized calcified lesion, CRA was diagnosed. We suspected that the congestive heart failure, refractory hypertension, and renal failure resulted from the supra-renal aortic stenosis. Because she developed oliguria with diuretics and vasodilators, we performed an open graft replacement with a thoracoabdominal approach. The reddish-brown calcified mass came off easily and was very fragile. The postoperative course was uneventful, and her heart and renal failure were completely resolved. This is the first report showing the fragility of CRA. Considering its fragility, catheter treatment may need to be avoided to prevent distal embolism. <Learning objective: When we encounter a calcified lesion localized at the level of the juxta and supra-renal aorta with extensive growth into the lumen, coral reef aorta (CRA) should be suspected. Considering that CRA lesion can be very fragile in contrast to the usual atherosclerotic lesion, as shown in our case, CRA might possibly increase the risk of distal embolization. Therefore, open graft replacement could be safer than endovascular stent-graft placement.>.
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PMID:Refractory heart failure and intermittent claudication secondary to supra-renal coral reef aorta. 3313 21


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