Stenosis of peripheral vascular stent
The ICD-10-CM is a catalog of diagnosis codes used by medical professionals for medical coding and reporting in health care settings. The Centers for Medicare and Medicaid Services (CMS) maintain the catalog in the U.S. releasing yearly updates.
Renal artery stenosis (RAS) is the narrowing of one or both renal arteries. “Renal” means “kidney” and “stenosis” means “narrowing.” The renal arteries are blood vessels that carry blood to the kidneys from the aorta—the main blood vessel that carries blood from the heart to arteries throughout the body.
Background: Renal dysfunction is an important factor of cardiovascular risk. Renal artery stenosis (RAS) is a potential cause of secondary hypertension and by renal ischemia may lead to progressive renal insuficiency.
Imaging tests commonly done to diagnose renal artery stenosis include:Doppler ultrasound. High-frequency sound waves help your doctor see the arteries and kidneys and check their function. ... CT scan. ... Magnetic resonance angiography (MRA). ... Renal arteriography.
However, renal artery stenosis is the primary cause of hypertension (ie, renovascular hypertension) only in certain settings. In most cases of renal artery stenosis, one kidney is affected, with the main vessels to the second kidney being essentially normal, hence the designation, "unilateral" disease.
The renal arteries are large blood vessels that carry blood from your heart to your kidneys. Renal is another word for kidney. You have two renal arteries. The right renal artery supplies blood to the right kidney, while the left artery sends blood to the left kidney.
The prevalence of renal artery stenosis is probably less than 1% of patients with mild hypertension but can increase to as high as 10 % to 40% in patients with acute (even if superimposed on a preexisting elevation in blood pressure), severe, or refractory hypertension.
More than 90% of the time, renal artery stenosis is caused by atherosclerosis, a process in which plaque made up of fats, cholesterol, and other materials builds up on the walls of the blood vessels, including those leading to the kidneys.
The kidneys play an important role in regulating blood pressure by secreting a hormone called renin. If the renal arteries are narrowed or blocked, the kidneys cannot work effectively to control blood pressure. Persistent or severe high blood pressure is a common symptom of renal artery stenosis.
Many but not all patients with atherosclerotic renal artery stenosis have chronic kidney disease (CKD) that is primarily due to a reduction in blood flow induced by the stenosis.
The pathophysiology of renal artery stenosis leads to changes in the structure of the kidney that are most noticeable in the tubular tissue. If the stenosis is longstanding and severe, the glomerular filtration rate in the affected kidneys never recovers and (prerenal) kidney failure is the result.
The long-term progression of RAS may also result in ischemic nephropathy development, contributing to subsequent chronic kidney disease. The rapid progression of RAS, reaching critical renal artery stenosis, is a possible aetiological factor of prerenal acute kidney injury (AKI).
Hemodynamically significant stenosis: a stenosis which decreases transstenotic blood flow or poststenotic blood pressure, or both. For a renal artery stenosis to produce renovascular hypertension, it must be of hemodynamic significance (4).