A Study on the Outcome of Percutaneous Transluminal Renal Angioplasty in Patients with Renal Failure

Successful non-surgical treatment of perirenal haematoma after percutaneous renal artery angioplasty in a solitary kidney

Renal artery angioplasty with stent placement represents an effective choice for correcting renal artery stenosis. However, if iatrogenic renal artery injury occurs, as in the case of solitary kidney, the risk of requiring chronic dialysis increases. This article reports the case of a patient with a solitary kidney, who underwent renal stenting and developed a retroperitoneal haematoma. The patient was managed conservatively and the perirenal haematoma resolved. Within the period of follow-up, the patient had maintained stable renal function with adequate blood pressure control.

Atherosclerotic renovascular disease and renal impairment: can we predict the effect of intervention?

Atherosclerotic renal artery stenosis (ARAS) is associated with hypertension, ischemic nephropathy, and high cardiovascular risk. We review the data on revascularization of the renal artery by percutaneous transluminal renal angioplasty (PTRA) and pharmacological therapy. In patients with severe ARAS and poorly controlled hypertension, PTRA can improve blood pressure control. In patients with rapid renal function loss and severe ARAS, PTRA can improve short-term renal function, but there is no evidence for long-term renoprotection. Recent evidence indicates that ARAS, and incidental renal artery stenosis, considerably increases cardiovascular risk, independent of blood pressure, renal function, and prevalent risk factors. This suggests that revascularization might potentially improve overall prognosis, but no data are available currently. The high cardiovascular risk warrants aggressive pharmacological treatment to prevent progression of the generalized vascular disorder. Ongoing trials will show whether revascularization has added, long-term effects on blood pressure, renal function, and cardiovascular prognosis.