title: Endovascular stent placement and magnetic resonance angiography for management of hypertension and renal artery occlusion during pregnancy.
abstract: BACKGROUND
  Severe renovascular hypertension carries serious maternal and fetal risk. In patients failing medical therapy, therapeutic options include surgical revascularization, nephrectomy, and percutaneous angioplasty.
  
  
  METHODS
  A pregnant woman with long-standing hypertension developed accelerated hypertension despite multiple drug therapy. Magnetic resonance angiography diagnosed an atrophic kidney with a critical proximal right renal artery lesion. At 17 weeks' gestation, this renal artery occlusion was treated with percutaneous angioplasty and endovascular stent placement; hypertension has improved markedly, allowing discontinuation and tapering of her antihypertensive medications. Total fetal radiation dose was 0.002 Gy.
  
  
  CONCLUSIONS
  Magnetic resonance angiography is a promising, noninvasive diagnostic method of evaluating renovascular hypertension during pregnancy. Transluminal angioplasty and endovascular stent placement can be performed safely and effectively with nominal fetal radiation exposure.
authors.affiliation: Department of Interventional Radiology, Hospital of the University of Pennsylvania, Philadelphia, USA.
authors.forename: T T
authors.initials: TT
authors.lastname: Le
authors.forename: Z J
authors.initials: ZJ
authors.lastname: Haskal
authors.forename: G A
authors.initials: GA
authors.lastname: Holland
authors.forename: R
authors.initials: R
authors.lastname: Townsend
mesh_terms: D000328:Adult; D000818:Animals; D001012:Aorta, Abdominal / Q000000981:diagnostic imaging; D001027:Aortography; D005260:Female; D006801:Humans; D006978:Hypertension, Renovascular / Q000601:surgery*; D018810:Magnetic Resonance Angiography / Q000379:methods; D051379:Mice; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular / Q000601:surgery*; D012078:Renal Artery Obstruction / Q000175:diagnosis*; D015607:Stents