DEAR DR. DONOHUE: My wife suffered a blockage in a coronary artery in 2005, and it was remedied by angioplasty and the placement of a stent.

More recently, an abdominal MRA scan showed an almost complete blockage of one of her kidney arteries. Can angioplasty and a stent be used to open up the flow of a kidney artery? A radiologist recommended angiography to give a clearer picture of her kidney circulation. What does that entail? – M.H.

ANSWER:
Do you appreciate the implications of all this? A blocked kidney artery can lead to two different problems. One is kidney damage, so the person’s blood cannot be cleansed as it should be. Lab tests can determine the extent of kidney damage.

The second possible problem is a rise in blood pressure. When a kidney gets less blood than it normally gets, it believes body blood pressure has dropped. To correct that mistaken impression, it pours out renin, a substance that raises blood pressure, and body pressure becomes elevated. That kind of high blood pressure is called renovascular hypertension, and is a correctable kind of high blood pressure.

I don’t know if your wife has high blood pressure or if she has any kidney damage. If she has either, angioplasty can often correct the situation. Angioplasty involves threading a balloon-tipped soft tube from a surface blood vessel to the blocked kidney artery. When the tip reaches the site of the blockage, the doctor inflates the balloon, which squashes the buildup. A stent can be put in place to prevent blockage from recurring. A stent is an expansible, metal device that keeps the artery propped open.

Angiography is injection of dye into an artery to get a clear X-ray picture of it. Angiography is often done to determine heart artery blockages.

DEAR DR. DONOHUE: I would appreciate any information on lipomas. In recent years I’m getting more of them. I am 79 and did not have them until five or six years ago. I have a large one in the middle of my back and a couple on my thighs. I have recently gotten two small ones on my lower arm. – M.B.

ANSWER:
Lipomas are noncancerous fatty tumors. About 1 percent of the population has one or more of them. No one knows the cause, so preventive treatment also remains unknown. However, if they cause pain by pressing on adjacent structures or if they are unsightly, they can be removed without much trouble, often as an outpatient.

Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475. Readers may also order health newsletters from www.rbmamall.com.


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