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| 복부 자상으로 발생한 신동맥 - 하대정맥루 및 신동맥류에 의한 신혈관성 고혈압 1예 |
| 박수정 , 민철홍 , 유석희 , 조대윤 , 김영구 |
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| Abstract |
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Renovascular hypertension is the most common cause of curable hypertension. Any lesion that obstructs either large or small renal arteries can cause renovascular hypertension. Although there are many screening tests for renovascular hypertension such as aMominal ultrasonography, captopril reno- gram, and pharmacologic screening with an ACE inhibitor, definite diagnosis has been made by a combination of selective renal angiography and renin measurement of differential renal vein. Its treatment can be divided surgical intervention and transluminal angioplasty. Recently selective embolization using embolic agents was introduced useful in the managernent of arteriovenous fistula and aneurysm. We report a case of renovascular hypertension with stab wound induced renal artery-IVC fistula and its distal renal artery aneurysm in a 23 year-old man. Functional ischemia, no organic stenosis, asso- ciated with decreased right renal artery perfusion due to shunt flow developed and was managed by simple closure of fistular site. After simple closure, blood flow of right renal artery was normalized and blood pressure was controlled. Thereafter, com- plicated autonephrectomy due to embolic obstruction during selective embolization of renal artery aneurysm was developed. |
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