Fracture of a Renal Artery Stent Due to Mobile Kidney

Annales de Chirurgie Vasculaire, 2010

Nous rapportons un cas de thrombose de l'art ere r enale r esultant d'une rupture de stent chez un malade avec un rein fonctionnel unique. Il etait revascularis e avec succ es chirurgicalement en d epit d'une isch emie r enale de plus de 48 heures. Cet article illustre le danger de g en eraliser le stenting des l esions de l'art ere r enale ind ependamment de l' etiologie. Un pi ege de l'art ere r enale doitêtre gard e a l'esprit comme cause possible de st enose de l'art ere r enale. Le traitement des pathologies compressives par stenting peut mener a l' echec du stent. La chirurgie demeure la meilleure approche pour le traitement de ce type de l esion.

Journal of Vascular and Interventional Radiology, 2008

The authors describe an incident of a type I single strut fracture in a right renal artery (RRA) stent resulting in ϳ90% restenosis. Fracture was observed just distal to the ostium approximately 1 year after implantation in an 83-year-old man with a history of systemic cardiovascular disease. In addition, a statistical analysis of the clinically reported cases of left renal artery (LRA) and RRA stent fracture is provided, which suggests a greater susceptibility to fracture in LRA stents as demonstrated by the greater occurrence (67%) in the left side.

Annals of Vascular Surgery, 2010

We report a case of renal artery thrombosis resulting from a stent fracture in a patient with a solitary functional kidney. It was successfully revascularized by surgical repair despite renal ischemia lasting more than 48 hours. This article illustrates the danger of generalizing endovascular stenting in renal artery disease regardless of the etiology. Renal artery entrapment must be kept in mind as a possible cause of renal artery stenosis. Treatment of compressive pathologies with stenting can lead to stent failure. Surgery remains the best approach for the treatment of this type of lesion.

Catheterization and Cardiovascular Interventions, 2011

An 80-year-old man received stent implantation for severe stenosis of the right renal artery. During the procedure, the proximal edge of the stent was successfully positioned at the ostium of the renal artery. After 6 months, follow-up renal angiography showed transverse stent fracture without restenosis. The proximal part of the fractured stent had moved and protruded into the abdominal aorta. Three years later, the proximal part of the fractured stent had migrated from the renal artery to the wall of infrarenal aorta. This is the first reported case of stent migration of the renal artery caused by a complete transverse stent fracture. V C 2011 Wiley-Liss, Inc.

Renal artery stenosis (RAS) is a common pathological condition associated with uncontrolled or refractory hypertension, flash pulmonary edema, and worsening renal function. The high prevalence of RAS in patients with coronary and lower extremity vascular disease has been well established. In a recent study on the practice of "drive-by renal shooting", prevalence of significant RAS was found to be high in patients with suspected coronary atherosclerosis referred for coronary angiography. Another study revealed dramatic increase in volume of renal arterial stenting in the Medicare population. Hence, concerns of over-diagnosis and over-treatment of RAS were raised. However, numerous recent studies demonstrated high success rate of renal artery stent revascularization and its clinical benefits. Aggressive screening and early treatment of RAS are therefore warranted in patients with drug-refractory hypertension and/or worsening renal insufficiency. However, some open issues remain. The paper proposes selection criteria for "drive-by renal shooting" and suggests valid criteria for treating RAS.

Journal of Medical Case Reports

Background: Secondary hypertension accounts for 5% of all cases of hypertension. Renal artery stenosis is one of the common causes of secondary hypertension. Atherosclerosis and fibromuscular dysplasia are the commonest types of stenosis associated with renal vascular hypertension, with the former accounting for 70-80% of all cases and the latter accounting for 10% of the incidence. The greatest incidence atherosclerosis is in men over the age of 40 years, mostly affecting the proximal part of the renal arteries, whereas fibromuscular dysplasia affects women ranging in age from 30 to 50 years. Currently, possible treatments are medical treatment using blood pressurelowering drugs, balloon angioplasty with or without stent insertion, and surgery to reconstruct the artery. Case presentation: We report a case of a 46-year-old Asian woman with stenosis of two branches of renal artery bifurcation treated by percutaneous balloon dilatation and stenting of both branches after referral to our department for a renal angiogram following 8 months of uncontrolled hypertension despite receiving medications. Initially, the patient presented with severe headache and fatigue. She was a known nonsmoker, was not diabetic, and had no history of diabetes in her family. She had no history of atherosclerosis. Apart from high blood pressure, the result of her physical examination was unremarkable. Laboratory investigations revealed normal serum cholesterol, lipid profile, and serum creatinine. She had been attending a hypertension clinic and receiving antihypertensive drugs for the past 8 months on a regular basis under close observation. Despite this treatment and care, her blood pressure remained high at 175/110 mmHg, which the attending doctor concluded to be uncontrolled blood pressure. Initial imaging indicated left renal artery stenosis, and the patient was referred to our department. Conclusions: For patients with uncontrolled hypertension despite receiving medications, renal Doppler ultrasound should be included in the diagnostic workup for secondary hypertension. Once renal artery stenosis is suspected, renal angiography is highly recommended because the technique is able to accurately diagnose stenosis in the branch arteries, unlike computed tomographic angiography and magnetic resonance angiography. Percutaneous transluminal renal angioplasty is the treatment of choice for renal artery stenosis in patients with renovascular hypertension or renal dysfunction.

American Journal of Roentgenology, 1993

Catheterization and Cardiovascular Diagnosis, 1993

A balloon-expandable (Palmaz-Schatzo) stainless steel stent was utilized following balloon angioplasty (PTRA) to determine if the obstructive lesion, using quantitative methods (automated measuring the diameter stenosis, and transstenotic peak systolic and mean pressure gradients), was significantly further reduced or abolished. Hemodynamic transstenotic gradient and stenoses measurements were made during 21 renal artery stenting procedures; prior and following PTRA, and subsequent to stent deployment. The stent sizes placed in the renal arteries were 5 mm (19%), 6 mm (67%), and 7 mm (14%). The results were as follows: Average Average (mmHg) (mmHg) p value Pre-procedure 50 & 22 94 f 33 82 2 12 -Post PTRA 8 2 6 23 f 19 29 2 14 c0.05 Post stent <1 2 1 < 1 * 3 3 k 6 C0.05 mean gradient peak gradient Percent stenosis

The anatolian journal of cardiology, 2020

Journal of Vascular Surgery, 2009

We report the case of a 71-year-old man with acute back and left flank pain caused by a large pseudoaneurysm of the left renal artery. The pseudoaneurysm resulted from a complete fracture of a stent that had been placed at the origin of this vessel 10 months earlier. Because the left kidney had no residual function, the patient was treated by percutaneous occlusion of the left renal artery with a vascular plug. The symptoms rapidly subsided, and he remained symptom free at the 6-month follow-up. Stent fractures, their complications, and management are discussed. ( J Vasc Surg 2009;49:214-6.) From the Departments of Vascular Surgery a and Interventional Radiology, b St. Antonius Hospital. Competition of interest: none.