case_images: PMC9808457_01
case_images: Computed tomography angiography, showing a focal stenosis in the left internal iliac artery (arrow) (A). Selective renal angiography, showing multiple stenosis and post stenotic dilatations (arrows) at distal sites of the right (B) and left (C) renal arteries.
case_images: gr1.jpg
case_images: PMC9808457_01_gr1.jpg
case_images: f0005
case_images: The bilateral renal artery stenoses were observed by CT angiography, which also demonstrated a focal stenosis in the left internal iliac artery (Fig. 1A). The selective renal angiography showed multiple stenoses and post stenotic dilatations at distal sites of bilateral renal arteries, which seemed to be unsuitable for endovascular therapy (Fig. 1B and C).
case_images: Coronary angiography, showing aneurysmal formation (arrows) of the proximal left anterior descending artery (LAD) and multiple stenotic and dilated lesions (arrowheads) in mid to distal LAD (A and B). The right coronary artery was diffusely ectasic and the atrioventricular node branch was totally occluded (C). The stenotic lesions were dilated by percutaneous coronary intervention (D).
case_images: gr2.jpg
case_images: PMC9808457_01_gr2.jpg
case_images: f0010
case_images: The coronary angiography revealed aneurysmal formation of the proximal left anterior descending artery (LAD) and multiple stenotic and dilated lesions of LAD (Fig. 2A and B), and the total occlusion of atrioventricular node branch of the right coronary artery (Fig. 2C).
case_images: Findings of intravascular ultrasound (IVUS) in left anterior descending artery (LAD). Proximal LAD revealed aneurysmal vessel enlargement (A). The IVUS images of the stenotic lesion showed lumen narrowing by circumferential thickening of intima with various echo intensity patterns; high intensity pattern (C and D) and relatively low echo intensity pattern (E and F). Lesion in proximal segment showed echolucent circumferential band inside the external elastic membrane which might indicate thickened media (B). There were no findings of intramural hematoma or spontaneous dissection. Adequate dilation was obtained after balloon angioplasty. G and H showed the IVUS image of same lesions at D and E after balloon dilation, respectively.
case_images: gr3.jpg
case_images: PMC9808457_01_gr3.jpg
case_images: f0015
case_images: The IVUS images of the stenotic lesion revealed lumen narrowing by circumferential thickening of intima with various echo intensity patterns; high intensity pattern (Fig. 3C and D) and relatively low echo intensity pattern (Fig. 3E and F). Lesion in proximal segment showed echolucent circumferential band inside the external elastic membrane which might indicate thickened media (Fig. 3B). The image of proximal LAD revealed aneurysmal vessel enlargement (Fig. 3A).