Percutaneous transluminal renal angioplasty with stenting for stenotic venous bypass grafts: report of two cases

Abstract

Cases of percutaneous transluminal renal angioplasty for renal artery stenosis are increasing. However, percutaneous transluminal renal angioplasty with stenting for stenotic venous bypass grafts has never been reported. Herein, the authors describe two cases of percutaneous transluminal renal angioplasty with stenting for a stenotic venous bypass graft. The patients in both cases had undergone bypass grafting using autologous saphenous veins, which were anastomosed directly to their abdominal aortas. We successfully conducted percutaneous transluminal renal angioplasty with stenting. One of the keys for technical success is an appropriate selection of guiding catheter compatible with postoperative nonanatomical vasculature, and the other is relatively high pressure dilation for venous stenosis.

Restenosis of Aorto-renal Venous Grafts: Report of Two Patients Treated by Endovascular Stenting

“…Surprisingly, despite its common use in the renal territory, there are, to the best of the authors' knowledge, only two papers (with three cases) published in the literature describing the endovascular treatment of stenosis in aorto-renal bypasses. 7 , 8 …”

“… 6 Restenosis of renal artery bypasses is always difficult to manage and, surprisingly, there are few descriptions of its treatment by an endovascular procedure, with only three cases reported in the literature. 7 , 8 …”

Hepatorenal Bypass for Renal Salvage: A Forgotten Option in the Endovascular Era

“…It is also feasible to use the hepatic artery for revascularization of the left renal artery. 7 Attention should be paid to the course of the hepatorenal bypass in relation to the porta hepatis, noting that placing the hepatic anastomosis on the most proximal segment of the common hepatic artery would allow a smooth course anterior to the porta hepatis.…”

“…More recently, The Society for Cardiovascular Angiography and Interventions produced a consensus statement supportive of renal artery stenting for global kidney ischemia associated with deteriorating function. 7 Nevertheless, there do remain potential complications associated with angioplasty and stenting including a deterioration in renal function due to embolization or vascular trauma, and for this reason, some suggest stricter patient selection might be used to reduce complications. 8,9 There has been no comparative study to examine the outcomes of endovascular treatment of RAS versus hepatorenal bypass surgery as a treatment of hypertension and renal failure.…”