how to understand, diagnose and treat Renovascular diseases.

2. Reno-vascular diseases Dr. Abrar Ali Katpar Resident AKU/Nephrology Medical Department King Khalid Hospital Hail, K.S.A

13. Proposed pathogenesis of renovascular hypertension.

21. Screening for renovascular diseases Diagnostic flowchart for the workup of renal artery stenosis.

25. Magnetic resonance angiography (MRA) showing renal artery stenosis. Courtesy of Patricia Stoltzfus, West Virginia University.

28. Angiogram showing bilateral renal artery stenosis. Courtesy of Henry Ford Hospital.

29. After percutaneous transluminal angioplasty (right renal artery). Courtesy of Department of Radiology, Henry Ford Hospital.

30. After percutaneous transluminal angioplasty & stent placement, Lt. renal artery. Courtesy of Department of Radiology, Henry Ford Hospital.

37. ACE-Inhibitor Augmented Scintigraphy

39. (2) Sonograms of the kidneys on a 46-year old woman with difficult to control hypertension showing uneven sizes of the kidneys the right kidney is 2.5 cm smaller in size. An isotope renogram obtained with technetium mercaptoacetyltriglycine (Tc-MAG3) shows a markedly depressed renal function in the right kidney (purple)

40. (3) Left, Flush aortogram in a 63-year-old man with hypertension shows marked stenosis of the right renal artery and complete occlusion of the left renal artery. Note the extensive atheroma in the aorta and iliac arteries. Right, nephrogram-phase image shows a significantly smaller left kidney with a faint nephrogram. Some blood supply to the left kidney is retained via collaterals (see image on the left).

41. (4) Digital subtraction flush aortogram in a 77-year-old normotensive man shows marked left renal artery stenosis and diffuse aortic atheroma. The patient presented with lower-limb claudication.

42. (5) Digital subtraction flush aortogram in an 83-year-old mildly hypertensive man shows complete occlusion of the left renal artery; only a stub of the artery is visualized. Note the diffuse aortic atheroma. The patient presented with lower-limb claudication.

43. (6) Three-dimensional phase- contrast MRA images of normal renal arteries.

44. (7) Dynamic gadolinium-enhanced MRA shows normal renal arteries.

47. (10) Technetium mercaptoacetyltriglycine (Tc-MAG3) isotopic renogram shows curves before and after angioplasty.

49. Captopril renogram

50. (11) Digital subtraction flush aortogram in a patient with a right iliac fossa transplanted kidney. Image shows stenosis at the anastomotic site associated with post-stenotic dilatation.

51. (12) Digital subtraction flush aortogram in a patient with a left iliac fossa transplanted kidney. Image shows an intrarenal branch stenosis associated with post-stenotic dilatation.

52. (13) Selective right renal angiogram shows standing waves in an intralobar artery. Standing waves in the renal arteries show as multiple serrated indentations that are symmetrically distributed at evenly spaced intervals. These of no pathologic significance and may represent arterial spasm. They may also affect intrarenal branches, as in this case.

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