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Case of the Month – February

By Dr Solokara Karunarathne

History:

73 year old male patient with persistent hypertension underwent imaging to exclude renal artery stenosis and adrenal masses.

Imaging:

CT Angiogram

Findings:

Heavy atheromatous calcification of abdominal aorta is present. There are 3 renal arteries each on both sides. Main left renal artery shows mild stenosis and main right renal artery is normal. 2 accessory renal arteries on right side and 2 on left side show moderate to severe stenosis. No adrenal masses.

Discussion:

Various antihypertensive treatment such as sympathetic denervation is less effective in accessory renal artery stenosis than that for single renal artery stenosis. Findings could potentially change the options for antihypertensive treatment.

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