title: Successful hybrid procedure in flash pulmonary edema.
abstract: A 70-year-old lady with recurrent flash pulmonary edema and acute coronary syndrome was detected to have bilateral renal artery disease and uncontrolled hypertension. Her right kidney size was 9.3 Χ 3.2 cm [glomerular filtration rate (GFR) 32.65 mL/min], left kidney size was 6.8 Χ 2.9 cm (GFR 12.78 mL/min), with a total GFR of 45.43 mL/min. Angiogram showed significant bilateral atherosclerotic renal artery stenosis and 90% right coronary artery lesion. She underwent successful percutaneous transluminal angioplasty of right renal artery lesion. Her serum creatinine of 1.6 mg/dL (GFR 45.43 mL/min) came down to 1.3 mg/dL (GFR 63 mL/min) post procedure and her blood pressure was controlled. She then underwent percutaneous transluminal coronary angioplasty of right coronary artery lesion. Renal artery stenosis is an important cause of uncontrolled hypertension and progression to chronic kidney disease. An early intervention and prompt revascularization prevents recurrent flash pulmonary edema and end stage kidney failure.
authors.affiliation: Institute of Cardiovascular Diseases, Madras Medical Mission, Mogappair, Chennai, India.
authors.forename: Thomas
authors.initials: T
authors.lastname: George
authors.forename: K
authors.initials: K
authors.lastname: Latchumanadhas
authors.forename: Georgi
authors.initials: G
authors.lastname: Abraham
authors.forename: S
authors.initials: S
authors.lastname: Devapriya
authors.forename: J
authors.initials: J
authors.lastname: Ezhilan
authors.forename: Ajit S
authors.initials: AS
authors.lastname: Mullasari
mesh_terms: D054058:Acute Coronary Syndrome / Q000628:therapy*; D000368:Aged; D000800:Angioplasty, Balloon; D015906:Angioplasty, Balloon, Coronary; D003324:Coronary Artery Disease / Q000628:therapy*; D005260:Female; D006801:Humans; D006973:Hypertension / Q000209:etiology; D011654:Pulmonary Edema / Q000209:etiology; D012078:Renal Artery Obstruction / Q000150:complications / Q000628:therapy*