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I once performed a renal duplex exam on a young woman who was  several hours
post partum with uncontrolled htn.  When she arrived for the study, she told
me she had just finished dinner.  I decided to try the exam anyway, and much
to my surprise, it was one of the best I've ever performed.  Her anatomy was
"text book" and her dinner (fortunately not gassy) laid out nicely in the
stomach, providing just the right enhancement.  The exam of course, was
normal.

Nancy Krupp

----- Original Message -----
From: "Stanley, Jeff" <[log in to unmask]>
To: <[log in to unmask]>
Sent: Friday, November 22, 2002 12:52 PM
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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