Refractory hypertension secondary to renal artery stenosis with a honeycomb-like structure

BMC Cardiovascular Disorders

Ying Zhang¹  Yan Lu¹  Wei Song¹  Da Yin¹  Yan Liu¹  Yunpeng Cheng¹  Yinong Jiang¹  Cheng Chen² 

[1] Department of Cardiology, The First Affiliated Hospital of Dalian Medical University, No. 222 Zhongshan Road, Zhongshan District, Dalian, Liaoning Province, China;Department of Cardiology, The First Affiliated Hospital of Dalian Medical University, No. 222 Zhongshan Road, Zhongshan District, Dalian, Liaoning Province, China;State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China;

关键词: Secondary hypertension;    Renal artery stenosis;    Honeycomb-like structure;    IVUS;    Case report;   

DOI  :  10.1186/s12872-021-02428-1

来源: Springer

【 摘 要 】

BackgroundA honeycomb-like structure (HLS) is a rare abnormality characterized by a braid-like appearance. Angiograph and intravascular examination, including coherence tomography and intravascular ultrasound (IVUS), can further confirm the multiple intraluminal channels or honeycomb structure, which can also be described as looking like ‘swiss cheese’, a ‘spider web’ or a ‘lotus root’. Previous studies have mostly reported this abnormality in coronary arteries, with a few cases in renal arteries. More information about the characteristics and development of HLS is needed.Case presentationA 69-year-old Han man with resistant hypertension received abdominal enhanced computerised tomography and was revealed to have left renal artery stenosis with the possibility of left renal infarction. Renal artery angiography confirmed a 95% stenosis located in the proximal segment of the left renal artery, and the middle segment was blurred with multi-channel-like blood flow. Further IVUS was performed and identified multiple channels surrounded by fibrous tissue. It was a rare case of HLS in the renal artery secondary to the thrombus, with organisation and recanalisation. Balloon dilatation and stent implantation at the proximal segment of the left renal artery were performed successfully. Blood pressure was well controlled after the procedure.ConclusionsThe IVUS findings are helpful for forming interventional therapeutic strategies for HLS lesions in the renal artery.

【 授权许可】

CC BY