ENDOVASCULAR STENT PLACEMENT AND MAGNETIC-RESONANCE ANGIOGRAPHY FOR MANAGEMENT OF HYPERTENSION AND RENAL-ARTERY OCCLUSION DURING PREGNANCY

Background: Severe renovascular hypertension carries serious maternal and fetal risk. In patients failing medical therapy, therapeutic optio ns include surgical revascularization, nephrectomy, and percutaneous a ngioplasty. Case: A pregnant woman with long-standing hypertension dev eloped accelerated hypertension despite multiple drug therapy. Magneti c resonance angiography diagnosed an atrophic kidney with a critical p roximal right renal artery lesion. At 17 weeks' gestation, this renal artery occlusion was stent placement; hypertension has improved marked ly, allowing discontinuation and tapering of her antihypertensive medi cations. Total fetal radiation dose was 0.002 Gy. Conclusion: Magnetic resonance angiography is a promising, noninvasive diagnostic method o f evaluating renovascular hypertension during pregnancy. Transluminal angioplasty and endovascular stent placement fan be performed safely a nd effectively with nominal fetal radiation exposure.