Successful directional atherectomy of eccentric renal artery stenosis using the Simpson directional coronary atherocath as a primary therapy.
A 67-yr-old female patient with accelerated hypertension, severe peripheral vascular disease, diabetes mellitus, and coronary artery disease had an abnormal renal scan, renal angiogram, and renal vein renin determination with lateralization to the left kidney. Angiography demonstrated a very tight, eccentric plaque obstructing the left renal artery of approximately 99%. Because of the anatomy of the plaque, balloon dilatation was deemed inadvisable. Subsequently, a Simpson 7F graft DCA atherocath through a four-curved 10F right bypass graft guiding catheter was used to successfully debulk the left renal artery. After debulking, the artery was dilated with a 5 mm Meditech balloon on a wire through a Cobra guiding catheter. The patient's blood pressure responded immediately and there were no complications. A large amount of atherosclerotic plaque was removed from the renal artery.
Kushner
F G
FG
West Jefferson Medical Center, Marrero, Louisiana.
Helm
M J
MJ
D000368:Aged; D015901:Angiography, Digital Subtraction; D000800:Angioplasty, Balloon / Q000295:instrumentation; D001027:Aortography; D017073:Atherectomy / Q000295:instrumentation*; D001026:Coronary Artery Bypass; D005260:Female; D006801:Humans; D006977:Hypertension, Renal / Q000000981:diagnostic imaging / Q000601:surgery; D011183:Postoperative Complications / Q000000981:diagnostic imaging / Q000601:surgery; D012078:Renal Artery Obstruction / Q000000981:diagnostic imaging / Q000601:surgery*