Renal artery thrombosis caused by stent fracture in a single kidney patient.
OBJECTIVE
To report a case of incomplete expansion, fracture, and thrombosis of a stent in the renal artery.


METHODS
A 47-year-old man with right renal artery occlusion underwent direct stenting of the left renal artery using a balloon-expandable stent. Completion angiography showed satisfactory patency of the vessel although the stent was not fully expanded in its central segment. The patient received 5000 units of heparin during the procedure, but no additional anticoagulant or antiplatelet therapy in the peri/postinterventional period. Twenty-five days later, he presented with acute renal insufficiency and uncontrolled hypertension. Angiography revealed in-stent thrombosis and collateral flow in the distal segment of the left renal artery. He underwent an aortorenal bypass, which salvaged the kidney. The stent, after removal from the vessel, was fractured and not completely expanded.


CONCLUSIONS
Incomplete expansion and fracture of the stent associated with insufficient antiplatelet therapy produced in-stent thrombosis. Collateral flow prevented kidney necrosis.
Bessias
Nikolaos
N
Department of Vascular Surgery, Red Cross Hospital of Athens, Greece.
Sfyroeras
Giorgos
G
Moulakakis
Konstantinos G
KG
Karakasis
Filippos
F
Ferentinou
Eleftheria
E
Andrikopoulos
Vassilios
V
D000792:Angiography; D001157:Arterial Occlusive Diseases / Q000000981:diagnostic imaging / Q000628:therapy*; D002404:Catheterization / Q000295:instrumentation* / Q000379:methods; D020878:Device Removal; D004867:Equipment Design; D004868:Equipment Failure; D005500:Follow-Up Studies; D006083:Graft Occlusion, Vascular / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery*; D006801:Humans; D007668:Kidney / Q000002:abnormalities*; D008297:Male; D008875:Middle Aged; D012077:Renal Artery; D018570:Risk Assessment; D015607:Stents / Q000009:adverse effects*; D013927:Thrombosis / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery; D016896:Treatment Outcome; D014654:Vascular Patency / Q000502:physiology; D014656:Vascular Surgical Procedures / Q000379:methods