Anatomy

The renal arteries usually arise from the abdominal aorta at the level of the L1/L2 vertebral interspace (10). As such, they are immediately inferior to the origin of the superior mesenteric artery. In most people the right renal artery is lower than the left and takes a longer, more caudal route behind the inferior vena cava to the kidney. The left renal artery commonly originates posterolaterally and the right slightly

Imaging of the Renal Arteries: Current Status Table 1 Clinical Predictors of RAS

Young hypertensive patients

Presence of peripheral or coronary vascular disease Accelerated or malignant hypertension Hypertension resistant to treatment Bruit heard on abdominal auscultation

Deterioration in longstanding, previously well-controlled hypertensives

Worsening renal function after the instigation of an ACE inhibitor

Renal impairment but minimal proteinuria

Flash pulmonary edema

Differential in kidney size >1.5 cm

Grade III or IV retinopathy

Abbreviations: RAS, renal artery stenosis; ACE, angiotensin-converting enzyme.

more anteriorly. The average arterial diameter is 6 mm (range 5-8 mm in females, 6-9 mm in males). The main artery splits into anterior and posterior divisions outside the renal hilum. The divisions give rise to four or five segmental arteries that in turn divide into interlobar, then arcuate, and finally interlobular arteries. The renal arteries are end arteries and receive approximately 20% of cardiac output. Accessory arteries are present in 20% to 25%, the commonest being to the lower pole. Their presence has no bearing on the likelihood of renal arterial disease, but they may make endovascular treatment more technically difficult.

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Blood Pressure Health

Your heart pumps blood throughout your body using a network of tubing called arteries and capillaries which return the blood back to your heart via your veins. Blood pressure is the force of the blood pushing against the walls of your arteries as your heart beats.Learn more...

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