A dual wire approach to severe ostial bifurcating renal artery stenosis.
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.
Lorin
Jeffrey D
JD
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
Hirsh
David S
DS
Attubato
Michael J
MJ
Sedlis
Steven P
SP
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