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Renal Arteries: Revascularization and Exclusion
Keith B. Quencer, MD; T. Gregory Walker, MD, FSIR
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KEY FACTS

  • Preprocedure

    • Procedure

      • Post Procedure

        • Outcomes

          TERMINOLOGY

          • Definitions

            • Renal artery stenosis (RAS): Fixed narrowing of renal artery (main or branch vessels)
              • May lead to refractory HTN, ischemic nephropathy, &/or pulmonary edema
            • Renal trauma grade
              • Grade 1
                • Small parenchymal contusion
                • Stable subcapsular hematoma
                  • Treatment: Conservative
              • Grade 2
                • Laceration < 1 cm in depth
                • Stable perirenal hematoma
                  • Treatment: Conservative
              • Grade 3
                • Laceration > 1 cm in depth
                  • No extension into collecting system
                  • Treatment: Conservative if stable, angiogram ± intervention if ongoing blood loss or hemodynamically unstable
              • Grade 4
                • Laceration that extends into collecting system
                • Vascular injury of main renal artery or vein
                • Expanding subcapsular or perinephric hematomas
                  • Treatment: Angiogram and embolization
              • Grade 5
                • Avulsion of renal hilum with devascularization of kidney
                • Complete laceration or thrombosis of main renal artery or vein
                • Ureteropelvic junction avulsion
                • Shattered kidney
                  • Treatment: Varied; nephrectomy often performed vs. observation if hemodynamically stable
            • Angiomyolipoma (AML)
              • Benign hamartomatous tumors
                • Variable amounts of blood vessels/muscle/fat
              • Abnormal blood vessels
                • No internal elastic lamina, disordered fibrotic smooth muscle cells
                • Prone to intratumoral aneurysm formation and rupture
              • 80% sporadic
                • Typically unilateral; often static/slowly growing
              • 20% associated with tuberous sclerosis complex (TSC)
                • Often bilateral/large; progressive growth
            • Renal artery aneurysm (RAA)
              • 2nd most common visceral aneurysm (15-22%) after splenic
              • Congenital causes (e.g., Ehlers-Danlos)
              • Acquired causes: Atherosclerosis/degenerative
              • Often asymptomatic
              • Possible symptoms
                • HTN/renal insufficiency from microemboli
                • Hematuria/flank pain from aneurysm rupture
              • Tend to occur at bifurcation of main renal artery
          • Epidemiology/Pathophysiology of Renal Artery Stenosis

            • Pathophysiology
              • Stenosis causes decreased renal perfusion
                • Renin released by juxtaglomerular cells
                • Renin activates angiotensin II production
                • Angiotensin II production causes efferent arteriole constriction and aldosterone elevation, leading to sodium/water retention
            • Causes
              • Atherosclerosis (90%)
                • Causative in 0.5-10.0% of all patients with HTN, ~ 30% of patients with accelerated HTN
                • Risk factors similar to atherosclerosis elsewhere
                • Affects ostium/proximal 1/3 of renal artery
                • Stenting definitively better than percutaneous transluminal angioplasty (PTA) for ostial atherosclerotic lesions
              • Fibromuscular dysplasia (FMD) (10%)
                • F > M (3-4:1)
                • Noninflammatory vasculitis
                  • Typically involves mid and distal main renal artery
                  • Beaded appearance from alternating areas of aneurysmal dilation and stenosis
                  • Long-segment stenosis of midrenal artery is medial hypoplasia or intimal fibroplasia subtypes of FMD seen in very young patients
                • Angioplasty alone effective
                  • Stent reserved for PTA failure/restenosis/complications (i.e., dissection, rupture)
              • Renal transplant arterial stenosis
                • Affects 5-10% of transplants
                • Causes
                  • External compression by peritransplant fibrosis
                  • Kink points at anastomosis
                  • Injury from vascular clamp used during surgery
            • Acute renal ischemia
              • Embolism from proximal source (e.g., atrial fibrillation or aortic plaque)
              • In situ thrombosis of stenotic renal artery
              • Iatrogenic from endovascular intervention

          PREPROCEDURE

          • Indications

            • Contraindications

              • Preprocedure Imaging

                • Getting Started

                  PROCEDURE

                  • Patient Position/Location

                    • Equipment Preparation

                      • Procedure Steps

                        • Findings and Reporting

                          • Alternative Procedures/Therapies

                            POST PROCEDURE

                            • Things to Do

                              OUTCOMES

                              • Problems

                                • Complications

                                  • Expected Outcomes

                                    Selected References

                                    1. Pini A et al: Assessment and management of transplant renal artery stenosis. a literature review. Ann Vasc Surg. 82:13-29, 2022
                                    2. Restrepo JCÁ et al: New trends and evidence for the management of renal angiomyolipoma: a comprehensive narrative review of the literature. J Kidney Cancer VHL. 9(1):33-41, 2022
                                    3. Lopez-Gonzalez DB et al: Interventional radiology in renal trauma. Semin Intervent Radiol. 38(1):113-22, 2021
                                    4. Persu A et al: Beyond atherosclerosis and fibromuscular dysplasia: rare causes of renovascular hypertension. Hypertension. 78(4):898-911, 2021
                                    5. Pisano A et al: Renal denervation for resistant hypertension. Cochrane Database Syst Rev. 11:CD011499, 2021
                                    6. Safian RD: Renal artery stenosis. Prog Cardiovasc Dis. 65:60-70, 2021
                                    7. Smith TA et al: Endovascular embolization in renal trauma: a narrative review. Ann Transl Med. 9(14):1198, 2021
                                    8. Hatano T et al: Renal angiomyolipoma with tuberous sclerosis complex: how it differs from sporadic angiomyolipoma in both management and care. Asian J Surg. 43(10):967-72, 2020
                                    9. Sos TA: Commentary: evidence for benefits of renal artery stenting is not compelling and illustrates pitfalls of retrospective studies. J Vasc Interv Radiol. 31(4):598-600, 2020
                                    10. Coccolini F et al: Kidney and uro-trauma: WSES-AAST guidelines. World J Emerg Surg. 14:54, 2019
                                    11. Li M et al: Efficacy and safety of mTOR inhibitors (rapamycin and its analogues) for tuberous sclerosis complex: a meta-analysis. Orphanet J Rare Dis. 14(1):39, 2019
                                    12. Prince M et al: When and how should we revascularize patients with atherosclerotic renal artery stenosis? JACC Cardiovasc Interv. 12(6):505-17, 2019
                                    13. Razik A et al: Angiomyolipoma of the kidneys: current perspectives and challenges in diagnostic imaging and image-guided therapy. Curr Probl Diagn Radiol. 48(3):251-61, 2019
                                    14. Ramaswamy RS et al: Renal embolization: current recommendations and rationale for clinical practice. Curr Urol Rep. 19(3):5, 2018
                                    15. Duan XH et al: Urgent transcatheter arterial embolization for the treatment of ruptured renal angiomyolipoma with spontaneous hemorrhage. Acta Radiol. 57(11):1360-5, 2016
                                    16. Flum AS et al: Update on the diagnosis and management of renal angiomyolipoma. J Urol. 195(4 Pt 1):834-46, 2016
                                    17. Hassani M: Takayasu arteritis associated with severe renovascular hypertension. Saudi J Kidney Dis Transpl. 27(2):402-6, 2016
                                    18. Kawarada O et al: Renovascular heart failure: heart failure in patients with atherosclerotic renal artery disease. Cardiovasc Interv Ther. 31(3):171-82, 2016
                                    19. O'Connor PJ et al: Endovascular treatment of renal artery stenosis in the post CORAL era. Curr Treat Options Cardiovasc Med. 18(8):48, 2016
                                    20. Sanidas EA et al: Renal fibromuscular dysplasia: a not so common entity of secondary hypertension. J Clin Hypertens (Greenwich). 18(3):240-6, 2016
                                    21. Vassallo D et al: Progress in the treatment of atherosclerotic renovascular disease: the conceptual journey and the unanswered questions. Nephrol Dial Transplant. 31(10):1595-605, 2016
                                    22. Andersen PE et al: Interventional treatment of renal angiomyolipoma: immediate results and clinical and radiological follow-up of 4.5 years. Acta Radiol Open. 4(7):2058460115592442, 2015
                                    23. Biederman DM et al: Tailoring the endovascular management of transplant renal artery stenosis. Am J Transplant. 15(4):1039-49, 2015
                                    24. Braga AF et al: Endovascular approach to transplant renal artery stenosis. Ann Transplant. 20:698-706, 2015
                                    25. Chen W et al: Transplant renal artery stenosis: clinical manifestations, diagnosis and therapy. Clin Kidney J. 8(1):71-8, 2015
                                    26. Coleman DM et al: Renal artery aneurysms. J Vasc Surg. 62(3):779-85, 2015
                                    27. Diego-Nieto A et al: Severe renal artery stenosis after renal sympathetic denervation. JACC Cardiovasc Interv. 8(11):e193-4, 2015
                                    28. Eom HJ et al: Transarterial embolisation of renal arteriovenous malformation: safety and efficacy in 24 patients with follow-up. Clin Radiol. 70(11):1177-84, 2015
                                    29. Frey GT et al: Image-guided renal intervention. Radiol Clin North Am. 53(5):1005-19, 2015
                                    30. Gross JA et al: Imaging of urinary system trauma. Radiol Clin North Am. 53(4):773-88, ix, 2015
                                    31. Kautza B et al: "Management of blunt renal injury: what is new?". Eur J Trauma Emerg Surg. 41(3):251-8, 2015
                                    32. Koukoulaki M et al: Successful endovascular treatment of transplant intrarenal artery stenosis in renal transplant recipients: two case reports. World J Transplant. 5(2):68-72, 2015
                                    33. Minocha J et al: Transcatheter renal interventions: a review of established and emerging procedures. J Clin Imaging Sci. 5:5, 2015
                                    34. Mohan IV et al: The management of renal artery stenosis: an alternative interpretation of ASTRAL and CORAL. Eur J Vasc Endovasc Surg. 49(4):465-73, 2015
                                    35. Muller A et al: Renal artery embolization-indications, technical approaches and outcomes. Nat Rev Nephrol. 11(5):288-301, 2015
                                    36. Murray TE et al: Transarterial embolization of angiomyolipoma: a systematic review. J Urol. 194(3):635-9, 2015
                                    37. Rankin T et al: Wunderlich syndrome: the role of the general surgeon. Am Surg. 81(3):E113-4, 2015
                                    38. Sasongko TH et al: Rapamycin and its analogues (rapalogs) for tuberous sclerosis complex-associated tumors: a systematic review on non-randomized studies using meta-analysis. Orphanet J Rare Dis. 10:95, 2015
                                    39. Schieda N et al: Ten uncommon and unusual variants of renal angiomyolipoma (AML): radiologic-pathologic correlation. Clin Radiol. 70(2):206-20, 2015
                                    40. Serafetinides E et al: Review of the current management of upper urinary tract injuries by the EAU trauma guidelines panel. Eur Urol. 67(5):930-6, 2015
                                    41. Tonolini M et al: Multidetector CT imaging of complications after laparoscopic nephron-sparing surgery. Insights Imaging. 6(4):465-78, 2015
                                    42. Valente ES et al: Takayasu's arteritis with renal artery stenosis diagnosed in a patient with 65 years old. J Bras Nefrol. 37(4):501-4, 2015
                                    43. Varennes L et al: Fibromuscular dysplasia: what the radiologist should know: a pictorial review. Insights Imaging. 6(3):295-307, 2015
                                    44. Cooper CJ et al: Stenting and medical therapy for atherosclerotic renal-artery stenosis. N Engl J Med. 370(1):13-22, 2014
                                    45. Konings R et al: Successful reversal of acute kidney failure by ultrasound-accelerated thrombolysis of an occluded renal artery. Case Rep Med. 2014:205646, 2014
                                    46. Takeuchi N et al: Ruptured renal arteriovenous malformation successfully treated by catheter embolization: a case report. BMC Res Notes. 7:19, 2014
                                    47. Tuna IS et al: Contrast-enhanced CT and MR imaging of renal vessels. Abdom Imaging. 39(4):875-91, 2014
                                    48. Zhu MS et al: Factors that can minimize bleeding complications after renal biopsy. Int Urol Nephrol. 46(10):1969-75, 2014
                                    49. Schroeder J: Peripheral Vascular Interventions: An Illustrated Manual. Thieme Publishing, 2013
                                    50. Szmigielski W et al: Renal trauma imaging: diagnosis and management. A pictorial review. Pol J Radiol. 78(4):27-35, 2013
                                    51. Olin JW, Sealove BA: Diagnosis, management, and future developments offibromuscular dysplasia. J Vasc Surg. 53(3):826-836.e1, 2011
                                    52. Sam K et al: Percutaneous embolization of iatrogenic arterial kidney injuries: safety, efficacy, and impact on blood pressure and renal function. J Vasc Interv Radiol. 22(11):1563-8, 2011
                                    53. Stone PA et al: Ten-year experience with renal artery in-stent stenosis. J Vasc Surg. 53(4):1026-31, 2011
                                    54. Cura M et al: Vascular malformations and arteriovenous fistulas of the kidney. Acta Radiol. 51(2):144-9, 2010
                                    55. Dworkin LD et al: Is there any reason to stent atherosclerotic renal artery stenosis? Am J Kidney Dis. 56(2):259-63, 2010
                                    56. Patel RA et al: Tips and tricks in renal artery angioplasty and stenting: angiography, stent placement, embolic protection, complications, and contrast induced nephropathy. Minerva Cardioangiol. 58(1):113-26, 2010
                                    57. Dworkin LD et al: Clinical practice. Renal-artery stenosis. N Engl J Med. 361(20):1972-8, 2009
                                    58. Ginat DT et al: Transcatheter renal artery embolization: clinical applications and techniques. Tech Vasc Interv Radiol. 12(4):224-39, 2009
                                    59. Lee SY et al: Embolization of renal angiomyolipomas: short-term and long-term outcomes, complications, and tumor shrinkage. Cardiovasc Intervent Radiol. 32(6):1171-8, 2009
                                    60. Safian RD et al: Refining the approach to renal artery revascularization. JACC Cardiovasc Interv. 2(3):161-74, 2009
                                    61. Davies MG et al: The long-term outcomes of percutaneous therapy for renal artery fibromuscular dysplasia. J Vasc Surg. 48(4):865-71, 2008
                                    62. Textor SC: Atherosclerotic renal artery stenosis: overtreated but underrated? J Am Soc Nephrol. 19(4):656-9, 2008
                                    63. Kubota Y et al: Transcatheter arterial embolization with N-butyl-2-cyanoacrylate (Hystoacryl) in two treatments for huge renal arteriovenous malformation. Hinyokika Kiyo. 53(5):307-10, 2007
                                    64. Cooper CJ et al: Stent revascularization for prevention of cardiovascular and renal events among patients with renal artery stenosis and systolic hypertension: rationale and design of the CORAL trial. Am Heart J. 152(1):59-66, 2006
                                    65. Poulakis V et al: Treatment of renal-vascular injury by transcatheter embolization: immediate and long-term effects on renal function. J Endourol. 20(6):405-9, 2006
                                    66. Chatziioannou A et al: Endovascular treatment of renal arteriovenous malformations. Urol Int. 74(1):89-91, 2005
                                    67. Dinkel HP et al: Blunt renal trauma: minimally invasive management with microcatheter embolization experience in nine patients. Radiology 223:723-30, 2002
                                    68. Yamakado K et al. Renal angiomyolipoma: relationships between tumor size, aneurysm formation and rupture. Radiology. 225:78-82, 2002
                                    69. Kawashima A et al: Imaging of renal trauma: a comprehensive review. RadioGraphics. 21: 557-74, 2001
                                    70. Defreyne L et al: Cirsoid renal arteriovenous malformation treated by endovascular embolization with n-butyl 2-cyanoacrylate. Eur Radiol. 10(5):772-5, 2000
                                    Related Anatomy
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                                    Related Differential Diagnoses
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                                    References
                                    Tables

                                    Tables

                                    KEY FACTS

                                    • Preprocedure

                                      • Procedure

                                        • Post Procedure

                                          • Outcomes

                                            TERMINOLOGY

                                            • Definitions

                                              • Renal artery stenosis (RAS): Fixed narrowing of renal artery (main or branch vessels)
                                                • May lead to refractory HTN, ischemic nephropathy, &/or pulmonary edema
                                              • Renal trauma grade
                                                • Grade 1
                                                  • Small parenchymal contusion
                                                  • Stable subcapsular hematoma
                                                    • Treatment: Conservative
                                                • Grade 2
                                                  • Laceration < 1 cm in depth
                                                  • Stable perirenal hematoma
                                                    • Treatment: Conservative
                                                • Grade 3
                                                  • Laceration > 1 cm in depth
                                                    • No extension into collecting system
                                                    • Treatment: Conservative if stable, angiogram ± intervention if ongoing blood loss or hemodynamically unstable
                                                • Grade 4
                                                  • Laceration that extends into collecting system
                                                  • Vascular injury of main renal artery or vein
                                                  • Expanding subcapsular or perinephric hematomas
                                                    • Treatment: Angiogram and embolization
                                                • Grade 5
                                                  • Avulsion of renal hilum with devascularization of kidney
                                                  • Complete laceration or thrombosis of main renal artery or vein
                                                  • Ureteropelvic junction avulsion
                                                  • Shattered kidney
                                                    • Treatment: Varied; nephrectomy often performed vs. observation if hemodynamically stable
                                              • Angiomyolipoma (AML)
                                                • Benign hamartomatous tumors
                                                  • Variable amounts of blood vessels/muscle/fat
                                                • Abnormal blood vessels
                                                  • No internal elastic lamina, disordered fibrotic smooth muscle cells
                                                  • Prone to intratumoral aneurysm formation and rupture
                                                • 80% sporadic
                                                  • Typically unilateral; often static/slowly growing
                                                • 20% associated with tuberous sclerosis complex (TSC)
                                                  • Often bilateral/large; progressive growth
                                              • Renal artery aneurysm (RAA)
                                                • 2nd most common visceral aneurysm (15-22%) after splenic
                                                • Congenital causes (e.g., Ehlers-Danlos)
                                                • Acquired causes: Atherosclerosis/degenerative
                                                • Often asymptomatic
                                                • Possible symptoms
                                                  • HTN/renal insufficiency from microemboli
                                                  • Hematuria/flank pain from aneurysm rupture
                                                • Tend to occur at bifurcation of main renal artery
                                            • Epidemiology/Pathophysiology of Renal Artery Stenosis

                                              • Pathophysiology
                                                • Stenosis causes decreased renal perfusion
                                                  • Renin released by juxtaglomerular cells
                                                  • Renin activates angiotensin II production
                                                  • Angiotensin II production causes efferent arteriole constriction and aldosterone elevation, leading to sodium/water retention
                                              • Causes
                                                • Atherosclerosis (90%)
                                                  • Causative in 0.5-10.0% of all patients with HTN, ~ 30% of patients with accelerated HTN
                                                  • Risk factors similar to atherosclerosis elsewhere
                                                  • Affects ostium/proximal 1/3 of renal artery
                                                  • Stenting definitively better than percutaneous transluminal angioplasty (PTA) for ostial atherosclerotic lesions
                                                • Fibromuscular dysplasia (FMD) (10%)
                                                  • F > M (3-4:1)
                                                  • Noninflammatory vasculitis
                                                    • Typically involves mid and distal main renal artery
                                                    • Beaded appearance from alternating areas of aneurysmal dilation and stenosis
                                                    • Long-segment stenosis of midrenal artery is medial hypoplasia or intimal fibroplasia subtypes of FMD seen in very young patients
                                                  • Angioplasty alone effective
                                                    • Stent reserved for PTA failure/restenosis/complications (i.e., dissection, rupture)
                                                • Renal transplant arterial stenosis
                                                  • Affects 5-10% of transplants
                                                  • Causes
                                                    • External compression by peritransplant fibrosis
                                                    • Kink points at anastomosis
                                                    • Injury from vascular clamp used during surgery
                                              • Acute renal ischemia
                                                • Embolism from proximal source (e.g., atrial fibrillation or aortic plaque)
                                                • In situ thrombosis of stenotic renal artery
                                                • Iatrogenic from endovascular intervention

                                            PREPROCEDURE

                                            • Indications

                                              • Contraindications

                                                • Preprocedure Imaging

                                                  • Getting Started

                                                    PROCEDURE

                                                    • Patient Position/Location

                                                      • Equipment Preparation

                                                        • Procedure Steps

                                                          • Findings and Reporting

                                                            • Alternative Procedures/Therapies

                                                              POST PROCEDURE

                                                              • Things to Do

                                                                OUTCOMES

                                                                • Problems

                                                                  • Complications

                                                                    • Expected Outcomes

                                                                      Selected References

                                                                      1. Pini A et al: Assessment and management of transplant renal artery stenosis. a literature review. Ann Vasc Surg. 82:13-29, 2022
                                                                      2. Restrepo JCÁ et al: New trends and evidence for the management of renal angiomyolipoma: a comprehensive narrative review of the literature. J Kidney Cancer VHL. 9(1):33-41, 2022
                                                                      3. Lopez-Gonzalez DB et al: Interventional radiology in renal trauma. Semin Intervent Radiol. 38(1):113-22, 2021
                                                                      4. Persu A et al: Beyond atherosclerosis and fibromuscular dysplasia: rare causes of renovascular hypertension. Hypertension. 78(4):898-911, 2021
                                                                      5. Pisano A et al: Renal denervation for resistant hypertension. Cochrane Database Syst Rev. 11:CD011499, 2021
                                                                      6. Safian RD: Renal artery stenosis. Prog Cardiovasc Dis. 65:60-70, 2021
                                                                      7. Smith TA et al: Endovascular embolization in renal trauma: a narrative review. Ann Transl Med. 9(14):1198, 2021
                                                                      8. Hatano T et al: Renal angiomyolipoma with tuberous sclerosis complex: how it differs from sporadic angiomyolipoma in both management and care. Asian J Surg. 43(10):967-72, 2020
                                                                      9. Sos TA: Commentary: evidence for benefits of renal artery stenting is not compelling and illustrates pitfalls of retrospective studies. J Vasc Interv Radiol. 31(4):598-600, 2020
                                                                      10. Coccolini F et al: Kidney and uro-trauma: WSES-AAST guidelines. World J Emerg Surg. 14:54, 2019
                                                                      11. Li M et al: Efficacy and safety of mTOR inhibitors (rapamycin and its analogues) for tuberous sclerosis complex: a meta-analysis. Orphanet J Rare Dis. 14(1):39, 2019
                                                                      12. Prince M et al: When and how should we revascularize patients with atherosclerotic renal artery stenosis? JACC Cardiovasc Interv. 12(6):505-17, 2019
                                                                      13. Razik A et al: Angiomyolipoma of the kidneys: current perspectives and challenges in diagnostic imaging and image-guided therapy. Curr Probl Diagn Radiol. 48(3):251-61, 2019
                                                                      14. Ramaswamy RS et al: Renal embolization: current recommendations and rationale for clinical practice. Curr Urol Rep. 19(3):5, 2018
                                                                      15. Duan XH et al: Urgent transcatheter arterial embolization for the treatment of ruptured renal angiomyolipoma with spontaneous hemorrhage. Acta Radiol. 57(11):1360-5, 2016
                                                                      16. Flum AS et al: Update on the diagnosis and management of renal angiomyolipoma. J Urol. 195(4 Pt 1):834-46, 2016
                                                                      17. Hassani M: Takayasu arteritis associated with severe renovascular hypertension. Saudi J Kidney Dis Transpl. 27(2):402-6, 2016
                                                                      18. Kawarada O et al: Renovascular heart failure: heart failure in patients with atherosclerotic renal artery disease. Cardiovasc Interv Ther. 31(3):171-82, 2016
                                                                      19. O'Connor PJ et al: Endovascular treatment of renal artery stenosis in the post CORAL era. Curr Treat Options Cardiovasc Med. 18(8):48, 2016
                                                                      20. Sanidas EA et al: Renal fibromuscular dysplasia: a not so common entity of secondary hypertension. J Clin Hypertens (Greenwich). 18(3):240-6, 2016
                                                                      21. Vassallo D et al: Progress in the treatment of atherosclerotic renovascular disease: the conceptual journey and the unanswered questions. Nephrol Dial Transplant. 31(10):1595-605, 2016
                                                                      22. Andersen PE et al: Interventional treatment of renal angiomyolipoma: immediate results and clinical and radiological follow-up of 4.5 years. Acta Radiol Open. 4(7):2058460115592442, 2015
                                                                      23. Biederman DM et al: Tailoring the endovascular management of transplant renal artery stenosis. Am J Transplant. 15(4):1039-49, 2015
                                                                      24. Braga AF et al: Endovascular approach to transplant renal artery stenosis. Ann Transplant. 20:698-706, 2015
                                                                      25. Chen W et al: Transplant renal artery stenosis: clinical manifestations, diagnosis and therapy. Clin Kidney J. 8(1):71-8, 2015
                                                                      26. Coleman DM et al: Renal artery aneurysms. J Vasc Surg. 62(3):779-85, 2015
                                                                      27. Diego-Nieto A et al: Severe renal artery stenosis after renal sympathetic denervation. JACC Cardiovasc Interv. 8(11):e193-4, 2015
                                                                      28. Eom HJ et al: Transarterial embolisation of renal arteriovenous malformation: safety and efficacy in 24 patients with follow-up. Clin Radiol. 70(11):1177-84, 2015
                                                                      29. Frey GT et al: Image-guided renal intervention. Radiol Clin North Am. 53(5):1005-19, 2015
                                                                      30. Gross JA et al: Imaging of urinary system trauma. Radiol Clin North Am. 53(4):773-88, ix, 2015
                                                                      31. Kautza B et al: "Management of blunt renal injury: what is new?". Eur J Trauma Emerg Surg. 41(3):251-8, 2015
                                                                      32. Koukoulaki M et al: Successful endovascular treatment of transplant intrarenal artery stenosis in renal transplant recipients: two case reports. World J Transplant. 5(2):68-72, 2015
                                                                      33. Minocha J et al: Transcatheter renal interventions: a review of established and emerging procedures. J Clin Imaging Sci. 5:5, 2015
                                                                      34. Mohan IV et al: The management of renal artery stenosis: an alternative interpretation of ASTRAL and CORAL. Eur J Vasc Endovasc Surg. 49(4):465-73, 2015
                                                                      35. Muller A et al: Renal artery embolization-indications, technical approaches and outcomes. Nat Rev Nephrol. 11(5):288-301, 2015
                                                                      36. Murray TE et al: Transarterial embolization of angiomyolipoma: a systematic review. J Urol. 194(3):635-9, 2015
                                                                      37. Rankin T et al: Wunderlich syndrome: the role of the general surgeon. Am Surg. 81(3):E113-4, 2015
                                                                      38. Sasongko TH et al: Rapamycin and its analogues (rapalogs) for tuberous sclerosis complex-associated tumors: a systematic review on non-randomized studies using meta-analysis. Orphanet J Rare Dis. 10:95, 2015
                                                                      39. Schieda N et al: Ten uncommon and unusual variants of renal angiomyolipoma (AML): radiologic-pathologic correlation. Clin Radiol. 70(2):206-20, 2015
                                                                      40. Serafetinides E et al: Review of the current management of upper urinary tract injuries by the EAU trauma guidelines panel. Eur Urol. 67(5):930-6, 2015
                                                                      41. Tonolini M et al: Multidetector CT imaging of complications after laparoscopic nephron-sparing surgery. Insights Imaging. 6(4):465-78, 2015
                                                                      42. Valente ES et al: Takayasu's arteritis with renal artery stenosis diagnosed in a patient with 65 years old. J Bras Nefrol. 37(4):501-4, 2015
                                                                      43. Varennes L et al: Fibromuscular dysplasia: what the radiologist should know: a pictorial review. Insights Imaging. 6(3):295-307, 2015
                                                                      44. Cooper CJ et al: Stenting and medical therapy for atherosclerotic renal-artery stenosis. N Engl J Med. 370(1):13-22, 2014
                                                                      45. Konings R et al: Successful reversal of acute kidney failure by ultrasound-accelerated thrombolysis of an occluded renal artery. Case Rep Med. 2014:205646, 2014
                                                                      46. Takeuchi N et al: Ruptured renal arteriovenous malformation successfully treated by catheter embolization: a case report. BMC Res Notes. 7:19, 2014
                                                                      47. Tuna IS et al: Contrast-enhanced CT and MR imaging of renal vessels. Abdom Imaging. 39(4):875-91, 2014
                                                                      48. Zhu MS et al: Factors that can minimize bleeding complications after renal biopsy. Int Urol Nephrol. 46(10):1969-75, 2014
                                                                      49. Schroeder J: Peripheral Vascular Interventions: An Illustrated Manual. Thieme Publishing, 2013
                                                                      50. Szmigielski W et al: Renal trauma imaging: diagnosis and management. A pictorial review. Pol J Radiol. 78(4):27-35, 2013
                                                                      51. Olin JW, Sealove BA: Diagnosis, management, and future developments offibromuscular dysplasia. J Vasc Surg. 53(3):826-836.e1, 2011
                                                                      52. Sam K et al: Percutaneous embolization of iatrogenic arterial kidney injuries: safety, efficacy, and impact on blood pressure and renal function. J Vasc Interv Radiol. 22(11):1563-8, 2011
                                                                      53. Stone PA et al: Ten-year experience with renal artery in-stent stenosis. J Vasc Surg. 53(4):1026-31, 2011
                                                                      54. Cura M et al: Vascular malformations and arteriovenous fistulas of the kidney. Acta Radiol. 51(2):144-9, 2010
                                                                      55. Dworkin LD et al: Is there any reason to stent atherosclerotic renal artery stenosis? Am J Kidney Dis. 56(2):259-63, 2010
                                                                      56. Patel RA et al: Tips and tricks in renal artery angioplasty and stenting: angiography, stent placement, embolic protection, complications, and contrast induced nephropathy. Minerva Cardioangiol. 58(1):113-26, 2010
                                                                      57. Dworkin LD et al: Clinical practice. Renal-artery stenosis. N Engl J Med. 361(20):1972-8, 2009
                                                                      58. Ginat DT et al: Transcatheter renal artery embolization: clinical applications and techniques. Tech Vasc Interv Radiol. 12(4):224-39, 2009
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