Frequency of renal artery stenosis among cohort of Jordanians undergoing drive-by renal angiography at time of conventional cardiac catheterization

To determine the frequency of renal artery stenosis [RAS] by performing routine renal angiography in a cohort of patients undergoing clinically indicated non-emergent coronary angiography. A secondary goal was to define potential variables which may predict RAS in this cohort. This was a prospective observational cross-sectional study whereby routine drive-by renal angiography was performed in 870 consecutive patients undergoing non-emergent coronary angiography at Queen Alia Heart Institute, Amman, Jordan during a 4-month period extending from January 2006 to April 2006. Patients were evaluated regarding the presence and severity of RAS. Renal artery stenosis has been defined as diameter stenosis >50% on conventional angiography. Univariate analysis and multivariate analysis were then performed to evaluate potential predictors for RAS. Renal artery stenosis was found in 21 patients leading to a very low frequency of 2.4%. In univariate analysis, significant association with RAS was found with age, female gender, coronary artery disease severity, systolic blood pressure and creatinine clearance. In multivariate analysis, the only significant predictors were female gender [odds ratio 6.61, confidence interval 1.73-25.31, and p=0.006] and creatinine clearance in males [odds ratio 1.97, confidence interval 1.21-3.67, p=0.004]. Low frequency of RAS was noticed in our study. Performing drive-by renal angiography may be not justified in Jordanians except in high risk subgroups for RAS

Accurate delineation of the course of anomalous left main coronary artery using dual angiographic 'dot and eye method and the noninvasive multislice computed tomography scanner: a case report

This report describes the use of the [dot and eye] catheter X-ray angiographic method with adjunctive multi-slice computed tomographic angiography in depicting the anterior course of an anomalous left main coronary artery originating from the right coronary sinus. We suggest that using both techniques provides the final answer to this technical challenge

cost of new therapies in cardiovascular care. Time for hope or despair for developing countries

In recent years, remarkable therapeutic advances have been made in the field of interventional cardiology with the introduction of statins, thienopyridines, such as clopidogrel and drug-eluting stents. Only a small minority in developing countries can afford these new treatment modalities, while the public health system would be rapidly bankrupted if it were to provide these modalities for all patients who might benefit from it. The purpose of this review article is to provide insight regarding the cost-effectiveness of these new treatment strategies and to address the added costs resulting upon their adoption and their appropriateness in developing countries

Crush technique of a complex bifurcational left renal artery stenosis

We report a case of bilateral renal artery stenosis treated via a femoral approach performed in two stages. In the first setting direct stenting of the right renal artery was performed. Four weeks later a complex left renal artery bifurcational stenosis was treated with a crush stenting technique to avoid side branch compromise. The crush technique provides excellent patency of the branch artery after stenting the main vessel. The immediate outcome of this technique is excellent; however, its long term consequences are not known and need further investigation