PMC5576012_01
PMC5576012_02
This is a three-dimensional reconstruction of the computed tomography angiogram to show the tight stenosis at the proximal third of the right renal artery (green arrow). Note that due to the mid-aortic syndrome there are large collaterals that have formed as a result.
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fig1
Unfortunately, 4 years later, the hypertension recurred, and further investigations revealed a stenosis at the junction of the proximal and middle thirds of the right limb of the graft with a significant pressure gradient of 44 mmHg (Fig. 1).
Histological analysis was conducted using haematoxylin and eosin staining. (A) A low power magnification (x25) showing the calcified plaque in the lumen of the synthetic graft (arrow). (B) The infiltration of the multinuclear giant cells (arrow) within the Dacron graft. (C) A multinuclear giant cell which has "engulfed" one of the fibrils of the Dacron graft into its cytoplasm. (B,C) High-power magnifications (x200) of details of the graft.
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Macrophages and multinuclear giant cells were visualised around the polyethylene terephthalate graft material, indicating the presence of a chronic foreign body response (Fig. 2).