Procedures Perfromed:
Bilateral Renal Angiogram
Aortagram- Root/Ascending
Bilateral s elective carotid angiogram with intracranial imaging
Finding:
Right main renal artery is a medium-sized vessel with 10-20 percent ostial stenosis, the rest of the vessel and branches are free of any stenosis.
Left main renal artery is a large vessel with 50 percent ostial proximal stenosis, there was no pressure gradient across the lesion, the rest of the vessel and brances are free of any stenosis.
Type 2 bovine aortic arch, normal size ascending aorta and aortic arch no aneurysm, no dissection, no significant plaque or calcification of the arch.
Innominate artery is a large normal vessel with left cartoid taken off the innominate artery.
Right common carotid artery is a large and a very tortuous vessel with moderate calcification and the 30 percent proximal portion stenosis.
Carotid bifurcation is free of any significant disease, right external carotid artery is widely patent.
Right proximal internal carotid artery has mild calcific plaque- 20 percent stenosis.
The rest of cervical right carotid artery, intracranial internal artery, right MCA/ACA are free of any significant disease, no aneurysm or dissection.
Left common carotid artery is a large and patent vessel with mild calcification and no stenosis.
Carotid bifurcation is free of any significant disease, left external carotid artery is widlely patent.
Left proximal internal carotid artery has mild calcific plaque- 10-15 percent stenosis.
The rest of cervical left carotid artery, intracranial internal artery, left MCA/ACA are free of any significant disease, no aneurysm or dissection.
Anterior communicating artery is patent.
Procedure Notes:
The patient was brought to the cath lab in resting and fasting state. The patient was prepped and draped in the usual and sterile fashion.
Vascular access obtained to the right femoral artery with micropuncture kit and modified seldinger technique, 5 french shealth introduced.
Bilateral selective renal angiogram obtained with 5 french IM catheter.
Aortic arch angiogram obtained at 40 degree LAO 1 with a 5 french pigtail catheter.
For selective carotid angiogram a 5 French JR4 coucatheter was placed selectively to right common carotid artery and left common carotid artery. Ortogonal views were taken. Towns and sagital intracranial views were taken.
Conclusions:
1. mild 20 percent right renal artery stenosis, moderate 50 percent left renal artery stenosis.
2. mild bilateral internal carotid artery atherosclerosis, no obstructive disease.
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