What is Renal Artery Stenosis?
When the artery to your kidney becomes narrowed or blocked, your kidney is tricked into thinking there is not enough blood volume in your body. This causes it to release hormones into the body that raise the blood pressure. Not only does this cause dangerously high blood pressure, but over time will result in kidney failure as not getting enough blood to the kidney will cause damage.
About 90% of RAS is caused by atherosclerosis – clogging, narrowing and hardening of the renal arteries. Most other cases of RAS are caused by fibromuscular dysplasia (FMD) – the abnormal development or growth of cells on the renal artery walls – which can cause blood vessels to narrow.
You are most at risk for RAS if you have atherosclerosis. Risk factors for RAS caused by atherosclerosis include:
- High blood cholesterol levels
- High blood pressure
- Lack of physical activity
- Family history of heart disease
In many cases, RAS has no symptoms until it becomes severe. Symptoms of a significant decrease in kidney function include:
- Increase or decrease in urination
- Edema – swelling, usually in the legs, feet or ankles
- Drowsiness or tiredness
- Appetite loss
- Nausea and/or vomiting
- Sleep problems
How is Renal Artery Stenosis treated?
If caught early, RAS can be treated with diet and medication to control blood pressure. After diagnosis of RAS with ultrasound, CT or MRI, we would treat your RAS with an Arteriogram with Stent Placement.
This intervention is usually performed as an outpatient procedure at ECCO with moderate sedation.
What is Arteriogram with Intervention?
“Arterio” means artery and “Gram” means picture. Before we treat anything, we create maps of your arteries using a dye that is injected into your arteries and we view its path through your arteries with the help of X-ray. We can see where the arteries are going, what they’re feeding and any obstructions or abnormalities.
Once we determine a diagnosis and proper treatment path, a local anesthetic will be administered to numb your skin. We then place a needle into the artery in your groin (femoral artery) or wrist (radial artery) using ultrasound to guide our needle.
This needle is hollow so that we can thread a wire through the needle and into the artery. We then place a sheath into the artery which is a one-way valve that allows us to maintain temporary access into the artery without any blood loss.
From here we may perform:
- Balloon Angioplasty: This means to use a balloon to open a narrowing or blockage in an artery. This is performed with a specialized catheter with an elongated balloon or its tip that is then inflated.
- Atherectomy: This means to remove plaque buildup in the arteries and is most commonly done in the legs, but can also be done in the heart. This is performed with specialized catheters that have laser or grinding functionality.
- Stent Placement: If angioplasty or atherectomy aren’t successful in restoring flow through an artery, a stent, or a tube made of metal wire, is placed to keep the vessel open. This is a permanent implant.
These procedures are done with moderate sedation at our facility and recovery time is minimal. A closure device is used to seal your artery which decreases recovery time and can cause some bruising or soreness at the access site.