PMC416478_01
PMC416478_02
July 2002 CT scan with intravenous contrast: Figure 1a shows no contrast in the right renal artery (blue arrow). Figure 1b nicely highlights contrast uptake by the left renal artery (red arrow). Both figures demonstrate atrophy of the right kidney while the left kidney enhances with contrast.
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F1
Review of the CT scan confirmed that the patient had no perfusion of his right kidney at the time of presentation (Figures 1a and 1b).
PMC416478_03
PMC416478_04
September 2002 magnetic resonance angiography demonstrates rightward spiraling dissection flap that involves the origins of the celiac, superior mesenteric and right renal arteries.
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F2
A dynamic enhanced MRA of the abdomen revealed an aneurysmal dilatation of the suprarenal aorta with the abdominal aorta containing a rightward spiraling dissection flap, involving the origins of the celiac axis, SMA and right renal artery (Figure 2).
PMC416478_05
Left renal arteriogram reveals stenosis of the left renal artery prior to stent placement (blue arrow).
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F3
A Magic Torque measuring guidewire (Boston Scientific, Natick, MA) was placed into the left renal artery and a left renal arteriogram was performed through a 7 french Balkin sheath (Cook Inc., Bloomington, IA) (Figure 3).
Post-stent arteriography demonstrates restoration of blood flow to the left kidney.
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F4
After the stent placement, angiography revealed improved blood flow to the left kidney (Figure 4).
PMC416478_06