Effect of Balloon Catheter Angioplasty Alone for Recurrent Bilateral Renal Artery Restenosis and Quick Deterioration for Hemodialysis: An Alternative for in-Stent Restenosis

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dc.contributor.authorLopes, Mariana Pezzuteen_US
dc.contributor.authorCafezeiro, Caio Rebouças Fonsecaen_US
dc.contributor.authorCalderaro, Danielaen_US
dc.contributor.authorKajita, Luiz Junyaen_US
dc.contributor.authorBortolotto, Luiz Aparecidoen_US
dc.contributor.authorMuela, Henrique C. Simboen_US
dc.contributor.authorMacedo, Thiago Andradeen_US
dc.date.accessioned2019-12-06T09:42:24Z
dc.date.available2019-12-06T09:42:24Z
dc.date.issued2019-05
dc.description.abstractAim: Atherosclerotic renal artery stenosis is one of the main causes of secondary hypertension and results in a progressive loss of renal function. This case reports recurrent hypertensive pulmonary edema and worsening renal function successfully treated with multiple percutaneous renal interventions. Presentation of the Case: A 62-year-old female patient was admitted for carotid endarterectomy. She had uncontrolled blood pressure and worsened renal function. Bilateral renal artery stenosis was diagnosed and endovascular procedure plus stent was performed in both renal arteries. She was discharged with an improvement in renal function and blood pressure. Three months later, she presented a sudden onset of pulmonary hypertensive edema. Renal arteriography confirmed bilateral in-stent restenosis and a new bilateral angioplasty plus stent was fulfilled. Six months later, new worsening of dyspnea, severe renal dysfunction, and new hospitalization were indicated renal replacement therapy. Renal arteriography showed again bilateral renal artery in-stent restenosis and bilateral balloon catheter angioplasty with no stent was performed. She was discharged, with no need for hemodialysis, improved blood pressure and proposal for further discussion about surgical revascularization. Discussion: When severe reduction of glomerular filtration rate occurs in hypertensive patients with high risk for atherosclerotic disease, it seems prudent to examine renal arteries. Once a diagnosis is made, if blood pressure control cannot be achieved, mainly associated with progressive renal dysfunction, it is recommended restoration of renovascular supply. Conclusion: Percutaneous renal intervention with no-stenting in bilateral in-stent restenosis and recent onset of hemodialysis may contribute to reversion of renal dysfunction even in patients undergoing to previous interventions.en_US
dc.identifier.affiliationsHeart Institute, University of São Paulo, São Paulo, Brazil.en_US
dc.identifier.affiliationsHeart Institute, University of São Paulo, São Paulo, Brazil.en_US
dc.identifier.affiliationsHeart Institute, University of São Paulo, São Paulo, Brazil.en_US
dc.identifier.affiliationsHeart Institute, University of São Paulo, São Paulo, Brazil.en_US
dc.identifier.affiliationsHeart Institute, University of São Paulo, São Paulo, Brazil.en_US
dc.identifier.affiliationsHeart Institute, University of São Paulo, São Paulo, Brazil.en_US
dc.identifier.affiliationsHeart Institute, University of São Paulo, São Paulo, Brazil.en_US
dc.identifier.citationLopes Mariana Pezzute, Cafezeiro Caio Rebouças Fonseca, Calderaro Daniela, Kajita Luiz Junya, Bortolotto Luiz Aparecido, Muela Henrique C. Simbo, Macedo Thiago Andrade. Effect of Balloon Catheter Angioplasty Alone for Recurrent Bilateral Renal Artery Restenosis and Quick Deterioration for Hemodialysis: An Alternative for in-Stent Restenosis. Cardiology and Angiology: An International Journal. 2019 May; 8(2): 1-6en_US
dc.identifier.issn2347-520X
dc.identifier.placeIndiaen_US
dc.identifier.urihttps://imsear.searo.who.int/handle/123456789/188711
dc.languageenen_US
dc.publisherScience Domain Internationalen_US
dc.relation.issuenumber2en_US
dc.relation.volume8en_US
dc.source.urihttps://doi.org/10.9734/ca/2019/v8i230098en_US
dc.subjectRenal artery stenosisen_US
dc.subjectpulmonary hypertensive edemaen_US
dc.subjecthypertensionen_US
dc.subjectpercutaneous renal interventionen_US
dc.titleEffect of Balloon Catheter Angioplasty Alone for Recurrent Bilateral Renal Artery Restenosis and Quick Deterioration for Hemodialysis: An Alternative for in-Stent Restenosisen_US
dc.typeJournal Articleen_US
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