Jeff,
I, too, am interested in the compensatory question. We have had a handful
of studies where pts present with either nephrectomy or occluded RA. THe
velocities in the contralateral RA are elevated-much like one would find in
the presence of a carotid occlusion.
I have not been able to locate any literature on this phenomenon in RA.
Would be interested if others have information.
Thanks
MaryAnne Waters
UVM
-----Original Message-----
From: Stanley, Jeff [mailto:[log in to unmask]]
Sent: Friday, November 22, 2002 12:53 PM
To: [log in to unmask]
Subject: Re: renal artery prep
I do about 3-5 renal arts per day and in the lateral decub. position I have
good success seeing the RA's in "large" pts. Most of my large pts probably
fall in the 200-250 lb range also. I think when you get over 300 the
success rate certainly drops. I've had beautiful RA studies in "large" pts
and, equally so, have had unsuccessful studies in "normal" size pts. More
often than not, I'm surprised I was able to see the RA's in those larger
pts. I think renal artery duplex success comes with experience as well as
the better quality imagers out there today, rather than size of pt. I have
my RA pts NPO after midnight, can take meds with clear liquids or water.
Luckily, I'm in a large cardiology office with Nuclear Medicine and most of
my RA pts are also having Stress Thallium studies and are NPO for that test.
When I worked in the hospital we did many RA studies just after patients ate
("Doctor wanted study done today") and have had just as much success in
those pts as well. I've found that in pts in which the RA's were difficult
to see, and after looking the next morning with the pt NPO, the RA's weren't
really any easier to see with the pt NPO. I think in general RA's are
either going to be fairly easy to see, or difficult to see, NPO or not.
Having said that I wouldn't do a RA study right after the pt ate, but found
that after about 4 hours the RA's can be seen for the most part.
Anyone have any references for renal artery duplex criteria status post
renal artery stent?
Also, when the other renal artery is occluded, or s/p nephrectomy, how much,
if any, compensatory flow would be expected in the lone renal artery?
Thanks,
Jeff Stanley BS,RVT
The Heart Group
Diagnostics-Vascular Lab
4230 Harding Road, Suite 330
Nashville, Tennessee 37205
(615) 565-6580
[log in to unmask]
-----Original Message-----
From: Waters, MaryAnne [mailto:[log in to unmask]]
Sent: Friday, November 22, 2002 10:43 AM
To: [log in to unmask]
Subject: Re: renal artery prep
Many of our patients are very large(200-250 lbs) I don't recall seeing pts
in excess of 300 lbs. I would think that those studies would be more
difficult.
We have very good success even with our large patients.
Positioning is key.
We book our renals for 60 minutes. That is normally adequate time for
completing the study and compiling the data into a report.
We do 3-4 renals daily.
MaryAnne Waters
UVM
-----Original Message-----
From: Thomas Vallot [mailto:[log in to unmask]]
Sent: Friday, November 22, 2002 11:19 AM
To: [log in to unmask]
Subject: Re: renal artery prep
Hello
I just have one question what is your success rate in patients 300lbs plus?
Does your success rate at seeing the renal artery drop? Also how long do you
spend on renal artery exams?.
Thanks Tom
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