PMC5843098_01
Chest computed tomography on admission shows moderately large bilateral pleural effusion more marked on the R side.
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Chest X-ray and computed tomographic scan showed bilateral pleural effusion without consolidation or infiltrate (Figure 1).
(A) Right renal artery: peak systolic velocity of 218.5 cm/s proximally, 48.5 cm/s at the midportion, and 63.3 cm/s distally. Prolonged systolic upstroke and slightly dampened systolic waveforms throughout the remainder of the renal artery. Ratio to aortic velocity is 1.7. (B) Left renal artery: peak systolic velocity of 197.2 cm/s proximally, 61.4 cm/s at the midportion, and 75.2 cm/s distally. Prolonged systolic upstroke and slightly dampened systolic waveform throughout the remainder of the renal artery. Ratio to aortic velocity is 1.5.
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Renal vascular duplex ultrasound and bilateral renal angiogram revealed high-grade stenosis of bilateral proximal renal arteries with 100% occlusion of the right (Figures 2 and 3).
Renal artery angiogram showing severe ostial stenosis of the left renal artery (arrow) as well as previously placed stent along the origin of superior mesenteric artery (asterisk).
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Renal vascular duplex ultrasound and bilateral renal angiogram revealed high-grade stenosis of bilateral proximal renal arteries with 100% occlusion of the right (Figures 2 and 3).