Renal artery stenosis complicated by an intraoperative rupture of renal artery: a case study

Renal artery stenosis (RAS) is a major contributor to the prevalence of secondary hypertension. Fibromuscular dysplasia and atherosclerosis are commonly responsible for the occurrence of the disease. Medical therapy is the primary means of treatment for RAS. However, surgical interventions for revascularization are also considered, in selected group of patients, which can effectively cure hypertension and chronic kidney disease. An older man presented at Venus hospital, Surat, Gujarat with the complaints of severe dyspnea, edema, uncontrolled hypertension and renal insufficiency. He was diagnosed RAS and was operatively managed with percutaneous transluminal renal angioplasty. Written consent was taken from the patient mentioned in the study. During the procedure, the renal artery got ruptured, which was managed by placing a covered stent. The patient was successfully treated for RAS, in spite of comorbidities and intraoperative complication. In the subsequent clinical follow-up, the patient was asymptomatic. There was marked reduction in serum creatinine levels and even the blood pressure improved significantly. Absence of post-operative complications and positive recovery of the patient signifies the fact that management of renal artery rupture with a covered stent is a convenient approach in acquiring effective haemostasis. This approach can be useful in managing any sort of vessel rupture, related to revascularization procedures

Search for intermediate-mass black hole binaries in the third observing run of Advanced LIGO and Advanced Virgo

International audienceIntermediate-mass black holes (IMBHs) span the approximate mass range 100−105 M⊙, between black holes (BHs) that formed by stellar collapse and the supermassive BHs at the centers of galaxies. Mergers of IMBH binaries are the most energetic gravitational-wave sources accessible by the terrestrial detector network. Searches of the first two observing runs of Advanced LIGO and Advanced Virgo did not yield any significant IMBH binary signals. In the third observing run (O3), the increased network sensitivity enabled the detection of GW190521, a signal consistent with a binary merger of mass ∼150 M⊙ providing direct evidence of IMBH formation. Here, we report on a dedicated search of O3 data for further IMBH binary mergers, combining both modeled (matched filter) and model-independent search methods. We find some marginal candidates, but none are sufficiently significant to indicate detection of further IMBH mergers. We quantify the sensitivity of the individual search methods and of the combined search using a suite of IMBH binary signals obtained via numerical relativity, including the effects of spins misaligned with the binary orbital axis, and present the resulting upper limits on astrophysical merger rates. Our most stringent limit is for equal mass and aligned spin BH binary of total mass 200 M⊙ and effective aligned spin 0.8 at 0.056 Gpc−3 yr−1 (90% confidence), a factor of 3.5 more constraining than previous LIGO-Virgo limits. We also update the estimated rate of mergers similar to GW190521 to 0.08 Gpc−3 yr−1.Key words: gravitational waves / stars: black holes / black hole physicsCorresponding author: W. Del Pozzo, e-mail: [email protected]† Deceased, August 2020