Renal artery

Renal artery – the pair terminal blood vessel departing from side surfaces of a ventral aorta and supplying with blood a kidney. Renal arteries bring blood in apical (apical), back, lower and front kidney segments. Only 10% of blood go to kidney marrow, and the most part (90%) – to cortical substance.

Structure of a renal artery

There are right and left renal arteries, each of which is divided into back and front branches, and they are in turn divided into segmented branches.

Segmented branches branch on interlobar branches which break up to the vascular grid consisting of arc arteries. Interlobular and cortical arteries, and also medullary branches from which blood arrives to shares (pyramids) of a kidney depart from arc arteries to the renal capsule. Everything together they form arches from which the bringing vessels depart. Each bringing vessel branches on the ball of capillaries captured by the capsule of a ball and the basis of a renal tubule.

The efferent artery also breaks up to capillaries. Capillaries braid tubules of kidneys, and then pass into veins.

The right artery from an aorta lies forward and directly, and then goes to a kidney, slantwise and down, behind the lower vena cava. The way of the left artery to hiluses renalis is much shorter. It moves in the horizontal direction and behind the left renal vein falls into a left kidney.

Stenosis of renal arteries

Stenosis call partial occlusion of an artery or its leading branchs. The stenosis develops as a result of an inflammation or a prelum of an artery a tumor, a dysplasia or atherosclerotic narrowing of a vessel. Fibromuscular a dysplasia represent group of damages at which there is a thickening of average, internal or subadventitious covers of a vessel.

At a stenosis of renal arteries work of a kidney because of its defective supply with blood is broken. Dysfunction of a kidney quite often leads to development of a renal failure. The stenosis of renal arteries is sometimes shown in sharp increase in the ABP. But most often this disease proceeds asymptomatically. The long stenosis of arteries can lead to an azotemia. The azotemia is shown in confusion of consciousness, weakness, fatigue.

Existence of a stenosis is usually defined by the KT-angiography, doppler sonography, by urofragiya, arteriography. In addition for identification of causes of illness carry out the analysis of urine, biochemical and general blood tests, define concentration of electrolytes.

For pressure decrease at a stenosis the combination of anti-hypertensive medicines with diuretics is usually appointed. When narrowing a gleam of a vessel more than for 75% apply surgical methods of treatment - balloon angioplasty, stenting.

Denervation of renal arteries

Endovascular surgeons apply a method of catheter sympathetic denervation of renal arteries to achievement of lasting anti-hypertensive effect.

Denervation of renal arteries – an effective anemic technique of treatment of a resistant hypertension. During the procedure to the patient enter a catheter which gets into arteries into a femoral artery. Then under a short-term anesthesia carry out radio-frequency cauterization of mouths of arteries from within. Cauterization destroys communication of esodic and efferent sympathetic nerves of arteries with a nervous system that leads to weakening of influence of kidneys on indicators of blood pressure. After cauterization the conductor is taken, and the place of a puncture of a femoral artery is closed by the special device.

After denervation there is a stable lowering of arterial pressure on 30–40 mm of mercury. for a year.

Thrombosis of a renal artery

Thrombosis of a renal artery – overlapping of a renal blood-groove the blood clot which came off extrarenal vessels. Thrombosis arises at an inflammation, atherosclerosis, an injury. In 20-30% of cases of fibrinferments happens bilateral.

At fibrinferment of a renal artery there is acute and severe pain in a waist, a kidney, in a back which extends in a stomach and sideways.

Besides, thrombosis can serve as the reason of sudden substantial increase of blood pressure. Very often at fibrinferment there is nausea, vomiting, a lock, body temperature increases.

Treatment of thrombosis complex: anticoagulating treatment and symptomatic therapy, surgical intervention.

Aneurism of a renal artery

Aneurism of a renal artery is a sacculate expansion of a gleam of a vessel due to existence in its wall of elastic fibers and absence muscular. Aneurism most often happens unilateral. It can be placed both intrarenalno, and ekstrarenalno. Clinically this pathology can be shown by a thromboembolism of vessels and arterial hypertension.

At aneurism of a renal artery operation is shown. There are 3 types of operation of this type of anomaly:

• artery resection;
• excision of aneurism with substitution of its defect a patch;
• anevrizmografiya – sewing up of an arterial wall the aneurism fabrics left after preliminary excision of its main part.

Anevrizmografiya is applied at multiple defeats of a vessel and aneurism of the big sizes.