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Unilateral Stent Implantation for Renal Function in Bilateral Atherosclerotic Renovascular Hypertension

A Case Report

First Department of Internal Medicine, School of Medicine, Division of Blood Purification, Department of Radiology, School of Medicine, Kanazawa University, and Kanazawa National Hospital, Kanazawa, Japan.

Kazuaki Shimizu, MD

First Department of Internal Medicine, School of Medicine, Division of Blood Purification, Department of Radiology, School of Medicine, Kanazawa University, and Kanazawa National Hospital, Kanazawa, Japan.

Yoshiaki Izumiya, MD

First Department of Internal Medicine, School of Medicine, Division of Blood Purification, Department of Radiology, School of Medicine, Kanazawa University, and Kanazawa National Hospital, Kanazawa, Japan.

Tamayo Kato, MD

First Department of Internal Medicine, School of Medicine, Division of Blood Purification, Department of Radiology, School of Medicine, Kanazawa University, and Kanazawa National Hospital, Kanazawa, Japan.

Hitoshi Yokoyama, MD

Division of Blood Purification, School of Medicine, Kanazawa University, Kanazawa, Japan.

Ken-ichi Kobayashi, MD

First Department of Internal Medicine, School of Medicine, Division of Blood Purification, Department of Radiology, School of Medicine, Kanazawa University, and Kanazawa National Hospital, Kanazawa, Japan.

Osamu Matsui, MD

Department of Radiology, School of Medicine, Kanazawa University, Kanazawa, Japan.

Takuyuki Ise, MD

Kanazawa National Hospital, Kanazawa, Japan.

Renal artery stenting improves or preserves renal function in patients with bilateral renovas cular disease and chronic renal insufficiency. An 80-year-old male was admitted to the hospital for elevated blood pressure accompanied by congestive heart failure. He had renal insufficiency and severe hypertension secondary to bilateral atherosclerotic renal artery stenosis. Unilateral renal artery stenting in the left kidney resulted in the recovery of renal function, whereas renal artery stenting in the right kidney was technically difficult due to a tortuous aorta. After the left unilateral stent implantation, the serum creatinine concentration decreased from 2.0 to 1.3 mg/dL, and control of his blood pressure required fewer antihypertensive drugs, namely a calcium antagonist, an angiotensin-converting enzyme inhibitor, and diuretics. Fifteen months after stenting, renal scintigraphy demonstrated improved function of the right kidney, despite severe renal artery stenosis, as well as improved function of the left kidney. Renal angioplasty or stenting should be attempted in bilateral atherosclerotic renovascular hypertension with renal insufficiency, even though it may only be successful unilaterally.

Angiology, Vol. 53, No. 3, 349-352 (2002)
DOI: 10.1177/000331970205300314


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