title: A dual wire approach to severe ostial bifurcating renal artery stenosis.
abstract: Percutaneous intervention with balloon expandable stents has proven to be an effective measure to enhance renal blood flow and control blood pressure in subjects with severe ostial renal artery lesions. A small cohort of these subjects have an ostial bifurcation, which complicates the approach to revascularization. In these cases there is a concern of creating a total side-branch occlusion during balloon expansion. We report two cases of an ostial lesion at a renal artery bifurcation revascularized by employing a sequential dilatation double guidewire technique. Using a single 7F sheath in each case, both renal artery branches were wired, and each branch was predilated and stented in a sequential fashion. Excellent angiographic results were obtained in both cases.
authors.affiliation: Division of Cardiology, VA New York Harbor Health System Manhattan Campus and New York University School of Medicine, New York, New York 10010, USA. Jeffery.Lorin@med.va.gov
authors.forename: Jeffrey D
authors.initials: JD
authors.lastname: Lorin
authors.forename: David S
authors.initials: DS
authors.lastname: Hirsh
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Attubato
authors.forename: Steven P
authors.initials: SP
authors.lastname: Sedlis
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000800:Angioplasty, Balloon; D006801:Humans; D008297:Male; D015641:Radiography, Interventional; D012077:Renal Artery / Q000000981:diagnostic imaging; D012078:Renal Artery Obstruction / Q000000981:diagnostic imaging / Q000628:therapy*; D012720:Severity of Illness Index; D015607:Stents; D016896:Treatment Outcome