Left Renal Artery Stenosis with Spasm

- Operator : Krishna Rocha-Singh

Left Renal Artery Stenosis with Spasm
- Operators: Krishna Rocha-Singh, Seung-Whan Lee
Clinical presentation
A 54-year old female was admitted with new onset resting chest pain for 6months. She had no other specific symptom. Coronary angiogram showed distal LCX significant stenosis. She was implanted zotarolimus stent in distal LCX. Renal angiogram was performed because she had uncontrolled hypertension despite medication.
Baseline coronary angiogram

1. Left renal angiogram showed 90% narrowing of left renal artery ostium (Figure 1)
2. Right renal angiogram showed 30-40% narrowing of right renal artery(Figure 2).

Procedure
A 7Fr sheath was inserted into the right femoral artery. The left renal artery ostium was engaged with a 7Fr RDC guiding catheter. On procedure day, left renal angiogram showed 60% narrowing of left renal artery ostium (Figure 3). Initially we planned measure the trans-stenotic pressure to determine the treatment. The stenosis is crossed with a 0.014" Soft guide wire for recording the trans-stenotic pressure. After discussion with panels we decided treatment with medication for left renal artery stenosis.
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