Renal artery stenosis and aneurysms associated with neurofibromatosis

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Renal artery stenosis and aneurysms associated with neurofibromatosis Myo Han, MD, Enrique Criado, MD Journal of Vascular Surgery Volume 41, Issue 3, Pages 539-543 (March 2005) DOI: 10.1016/j.jvs.2004.12.021 Copyright © 2005 The Society for Vascular Surgery Terms and Conditions

Fig 1 Preoperative selective right renal arteriogram revealing tight stenoses of the proximal aspect of the segmental arteries with aneurysmal dilatation, and multiple aneurysms and stenosis of the segmental branches. Journal of Vascular Surgery 2005 41, 539-543DOI: (10.1016/j.jvs.2004.12.021) Copyright © 2005 The Society for Vascular Surgery Terms and Conditions

Fig 2 Postoperative selective right iliac arteriogram revealing patency of the reconstructed main renal artery and lower segmental branches, and residual stenosis of an upper segmental artery at the level of the hilum. Journal of Vascular Surgery 2005 41, 539-543DOI: (10.1016/j.jvs.2004.12.021) Copyright © 2005 The Society for Vascular Surgery Terms and Conditions

Fig 3 Renal artery specimen with hematoxylin and eosin stain. Top, Histologic examination of the renal artery, in low power (magnification ×15, showing obliterative stenosis with intimal and medial proliferative nodules of spindle cells with marked increased in the mucoid matrix. Middle, Intimal proliferative lesion obstructing the lumen of a small renal hilar artery. Magnification ×40. Bottom, High-power view (magnification ×100) of the renal artery showing irregular thinning and loss of medial smooth muscle and elastic lamina. A residual segment of the hypogastric artery (not shown) also showed similar intimal and medial proliferative nodules of spindle cells, possible fibroblasts or smooth muscle cells. Journal of Vascular Surgery 2005 41, 539-543DOI: (10.1016/j.jvs.2004.12.021) Copyright © 2005 The Society for Vascular Surgery Terms and Conditions

Fig 4 Renal artery aneurysm with elastin trichrome stain demonstrating outpouching of the vessel wall with intimal proliferation, and attenuation of the media and elastic lamina. Magnification ×40. Journal of Vascular Surgery 2005 41, 539-543DOI: (10.1016/j.jvs.2004.12.021) Copyright © 2005 The Society for Vascular Surgery Terms and Conditions