Slides Endovascular Renal
Both Renal Artery Stenosis Treated with Stenting
- Operator : Seung-Jung Park
Both Renal Artery Stenosis Treated with Stenting |
- Operator: Seung-Jung Park, MD |
Case Presnetation |
A 65-year old man was admitted due to exertional chest pain for 6 months. His risk factors were hypertension and diabetes mellitus. The hypertension has not been treated well despite anti-hypertension combination therapy with beta-blocker, calcium channel blocker, diuretics, and ACE inhibitor. His thallium SPECT showed reversible medium-sized moderate perfusion defect in the postero-lateral wall and the echocardiogram showed concentric LV hypertrophy and normal wall motion. The coronary angiogram showed diffuse three vessel disease and the renal angiogram showed 80% discrete ostial stenosis of both renal arteries (Figure 1). His creatinine was 1.4mg/dL. We planned angioplasty with stenting at both renal ateries prior to coronary artery bypass surgery. |
Interventional Procedure |
An 8Fr RDC catheter was positioned at the left renal artery (Figure 2) and the lesion was predilated with Powerflex balloon(4.0/20mm) at 10atm(4.0mm) (Figure 3). The following angiogram showed significant residual stenosis (Figure 4) and a Renal Palmaz Genesis Stent(6.0/15mm) was deployed at 14atm(6.4mm) (Figure 5, Figure 6, Figure 7). Then the catheter was engaged into right renal artery and predilation was performed with the stent balloon (6.0/15mm) at 6 atm(5.38mm) (Figure 8). Following angiogram showed renal artery dissection (Figure 9) and another Renal Palmaz Genesis Stent(6.0/18mm) was deployed at 12atm(6.2mm) (Figure 10, Figure 11, Figure 12). The final angiogram showed no residual narrowing at both renal artery ostium (Figure 7, Figure 12). |
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