RENAL ARTERY STENOSIS WITH STENT IN STENT – OUR EXPERIENCE
Sze Fung Alinda Chiu1, Sarah June Mcbride 1, Stephanie Ann Lam 1, Ashwani bhoopal Chakaravarthy 1 1Peninsula health, Frankston, Victoria, Australia
Abstract
Mrs TH presented with acute shortness of breath, bilateral ankle oedema and systolic blood pressure of 220. Past medical history includes right renal artery stent 2021. Chronic kidney disease EGFR of 40, hypertension, Ischaemic heart disease with coronary stent in right coronary artery 2009, chronic obstructive airway disease, rheumatoid arthritis and hyperlipidaemia. She had flash pulmonary oedema complicated by acute on chronic kidney disease non oliguria with serum Creatinine peaking at 520 (egfr 8 ) from 150. She was haemodialysis dependent and was put on multiple hypertensives. MAG3 scan reported right kidney 67% and left kidney 33%. Ultrasound reported right kidney of 10 cm and left kidney 8 cm (Small kidney) CT angiography reported no infarct in both kidneys. There was collateral circulation on the left kidney from lumbar and intercostal muscles despite thrombosed left renal artery. Right renal artery stent was thrombosed. The occlusion was traversed with a Progreat microcatheter and the tract was angioplastied with a 4 mm balloon catheter. A self-expanding stent was deployed. Post procedure her blood pressure improved and antihypertensives were weaned. Her kidney function normalised to her usual baseline eGFR of 38. Her haemodialysis was stopped. Oral Plavix was commenced. To date, Mrs TH is doing well, dialysis free and on weaning of medications for hypertension.
Biography
Bio to come