Stenting of the renal artery to improve renal function prior to thoracoabdominal aneurysm repair.
OBJECTIVE
To report the successful staged treatment of a patient with a thoracoabdominal aortic aneurysm (TAA), who presented with renal insufficiency attributable to renal artery stenosis.


RESULTS
A 66-year-old woman with a 6-cm Crawford type IV TAA presented with uncontrolled hypertension (240/130 mmHg), worsening congestive heart failure, and progressive renal insufficiency (serum creatinine 3.8 mg/dL) caused by renal artery stenosis to a solitary functioning kidney. Renal artery stenting restored normal renal and pulmonary function, and elective TAA repair 6 weeks after percutaneous stenting was uneventful. Restenosis (50% diameter reduction) in the renal artery was found 10 months later and treated with repeat dilation. Secondary patency was maintained at follow-up 21 months after redilation.


CONCLUSIONS
It appears feasible to use preliminary renal artery stenting to reduce operative risk in TAA surgical candidates with renal insufficiency secondary to renal artery stenosis.
Sullivan
T M
TM
Department of Vascular Surgery, The Cleveland Clinic Foundation, Ohio 44195, USA.
Hertzer
N R
NR
D058186:Acute Kidney Injury / Q000209:etiology; D000368:Aged; D017544:Aortic Aneurysm, Abdominal / Q000150:complications / Q000601:surgery*; D017545:Aortic Aneurysm, Thoracic / Q000150:complications / Q000601:surgery*; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D011300:Preoperative Care; D012008:Recurrence; D012078:Renal Artery Obstruction / Q000150:complications / Q000628:therapy*; D015607:Stents