Rupture of the renal artery after cutting balloon angioplasty in a young woman with fibromuscular dysplasia.
A 24-year-old woman with uncontrollable high blood pressure for 3 months had significant stenosis of the left renal artery caused by fibromuscular dysplasia (FMD). The lesion was resistant to percutaneous transluminal angioplasty at 18 atm with a semicompliant balloon. Angioplasy with a 6 x 10 mm cutting balloon (CB) caused rupture of the artery. Low-pressure balloon inflation decreased but did not stop the leak. An attempt to place a stent-graft (Jostent; Jomed, Rangendingen, Germany) failed, and a bare, 6-mm balloon-expandable stent (Express SD; Boston Scientific, MN) was deployed to seal the leak, which had decreased considerably after long-duration balloon inflation. The bleeding continued, and the patient underwent emergent surgical revascularization of the renal artery with successful placement of a 6-mm polytetrafluoroethylene bypass graft. CBs should be used very carefully in the treatment of renal artery stenosis, particularly in patients with FMD.
Oguzkurt
Levent
L
Department of Radiology, Adana Teaching and Medical Research Centre, Baskent University, Dadaloglu Mah 39, Sok No. 6, Yuregir, Adana 01250, Turkey. loguzkurt@yahoo.com
Tercan
Fahri
F
Gulcan
Oner
O
Turkoz
Riza
R
D000328:Adult; D000800:Angioplasty, Balloon / Q000009:adverse effects*; D016063:Blood Loss, Surgical; D001807:Blood Vessel Prosthesis; D019917:Blood Vessel Prosthesis Implantation; D002404:Catheterization; D005260:Female; D005352:Fibromuscular Dysplasia / Q000150:complications*; D005500:Follow-Up Studies; D006801:Humans; D011138:Polytetrafluoroethylene; D012077:Renal Artery / Q000293:injuries*; D012078:Renal Artery Obstruction / Q000628:therapy*; D012421:Rupture
D011138:Polytetrafluoroethylene