Key result
Echo-Doppler velocimetry identifies severe renal artery stenosis at ~3.4 m/s velocity, guiding successful angioplasty.
Case Report (n=1)
No
Echo-Doppler velocimetry can detect renal artery stenosis in pediatric hypertension even when plasma renin-angiotensin-aldosterone levels, captopril testing, and renal scintigraphy are normal.
Answers are grounded in this paper and cite their sources.
Echo-Doppler detected renal artery stenosis missed by functional tests in pediatric hypertension; hypothesis-generating and should not yet change practice.
A 13 year old boy suffering hypertension was examined for peripheral plasma renin, angiotensin-I, angiotensin-II and aldosterone. All data were within the normal range. The Captopril test and renal scintigraphy (both with and without Captopril) also showed normal patterns. Echo-Doppler velocimetry of the renal artery revealed that left renal arterial peak flow velocity was fast (3.4 m/s). The patient was therefore diagnosed with left renal arterial stenosis. Angiography demonstrated the duplex of the left renal artery and stenosis of the left lower renal artery. Percutaneous transluminal angioplasty was successfully performed.
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Fuse et al. (1996) conducted a case report in Renovascular hypertension and left renal arterial stenosis (n=1). Echo-Doppler velocimetry of the renal artery followed by percutaneous transluminal angioplasty was evaluated on Diagnosis and treatment of left renal arterial stenosis. Echo-Doppler velocimetry detected fast left renal arterial peak flow velocity, enabling diagnosis of renal artery stenosis and successful percutaneous transluminal angioplasty.
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